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Voith LA, Salas Atwell M, D'Alessio AS, Evans KE, Korsch-Williams A. Examining adverse childhood experiences and Black youth's engagement in a hospital-based violence intervention program using administrative data. Acad Emerg Med 2024. [PMID: 38605493 DOI: 10.1111/acem.14920] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Abstract] [Grants] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 10/02/2023] [Revised: 03/18/2024] [Accepted: 03/26/2024] [Indexed: 04/13/2024]
Abstract
BACKGROUND Stemming from poverty and systemic racism, Black youth are disproportionately represented in hospital-based violence intervention programs (HVIPs) due to greater violence exposure. HVIPs are a critical intervention that have been shown to reduce rates of reinjury in urban hospitals and trauma centers across the United States; however, they are plagued by low enrollment and engagement rates. Few studies have examined factors related to engagement, particularly among Black youth. METHODS Guided by Trauma Theory and Critical Race Theory, this study uses a retrospective cohort design. Between-group differences of adverse childhood experiences (ACEs) among engaged youth compared to nonengaged youth who were violently injured and recruited for a HVIP were examined using chi-square and logistic regression. ACEs were approximated using a novel approach with administrative data. RESULTS Results indicated that the total ACE score was not significantly associated with engagement status. Individual ACEs were tested across age groups. CONCLUSIONS This study highlights a novel approach to understanding ACEs among a hard-to-reach population and illuminates the significant level of ACEs faced by violence-exposed Black youth at young ages. Considering theory, Black families may be more reluctant to engage due to fear and past harms in social service systems stemming from systemic racism. Though ACEs did not predict engagement in this study, considering the high rates of ACEs experienced by Black youth and their families in the context of systemic racism suggests that HVIPs should acknowledge historical harms and foster trauma-informed and healing-centered interactions during recruitment and later stages of engagement.
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Affiliation(s)
- Laura A Voith
- Jack, Joseph and Morton Mandel School of Applied Social Sciences, Case Western Reserve University, Cleveland, Ohio, USA
- Center on Trauma and Adversity, Cleveland, Ohio, USA
| | - Meghan Salas Atwell
- National Association for the Education of Young Children, Washington, DC, USA
| | - Alena Sorensen D'Alessio
- Gillings School of Global Public Health, The University of North Carolina at Chapel Hill, Chapel Hill, North Carolina, USA
| | | | - Amy Korsch-Williams
- Jack, Joseph and Morton Mandel School of Applied Social Sciences, Case Western Reserve University, Cleveland, Ohio, USA
- Center on Trauma and Adversity, Cleveland, Ohio, USA
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LaMonica-Weier A, Perlia Bavis M. Kids First: A Multicomponent Onboarding for Practitioner Students in a School-Based Health Center. J Sch Nurs 2024; 40:231-236. [PMID: 35253498 DOI: 10.1177/10598405221085682] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Abstract] [Key Words] [MESH Headings] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 11/16/2022] Open
Abstract
School-Based Health Centers (SBHCs) often serve vulnerable populations who have been exposed to adverse childhood experiences (ACEs) which have been tied to an increase in adult health risk factors. At an urban SBHC serving adolescent students, 75% of patients reported three or more ACEs. This SBHC also had multiple practitioner students. A multicomponent onboarding was created to implement the Patient Interaction Standard of Care, addressing the SBHC model, adolescent care, and ACEs. Practitioner students that completed the onboarding demonstrated 97% adherence to the Patient Interaction Standard of Care "Always" or "Most of the Time." By onboarding frequent practitioner students, care provided to this vulnerable patient population was more consistently aligned to evidenced-based care appropriate for the SBHC model, adolescent care, and ACEs. This demonstrates the importance of mandatory onboarding completion compliance and further implementation across other SBCHs.
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Albdour M, Templin T, Zilioli S, Hong JS, Lumley MA. Current and Cumulative Stress Experiences: A Model for Arab American Young Adults. J Am Psychiatr Nurses Assoc 2024; 30:364-377. [PMID: 36217725 DOI: 10.1177/10783903221110235] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Abstract] [Key Words] [MESH Headings] [Track Full Text] [Journal Information] [Submit a Manuscript] [Subscribe] [Scholar Register] [Indexed: 11/15/2022]
Abstract
BACKGROUND The effect of multiple stressors on immigrant young adults' endocrine functioning and health outcomes has not been comprehensively investigated. AIMS This study tested a theoretical model of cumulative and current stressor effects on the hypothalamic-pituitary-adrenocortical (HPA) axis functioning and health-related quality of life (HRQL) among Arab American young adults. METHODS Using a cross-sectional design, we recruited 160 participants, ages 18 to 24 years, from an urban university in the Midwest. Cumulative stress was assessed by self-report measures of childhood adversity, bullying victimization, and perceived ethnic discrimination. Current perceived stress was measured using the Perceived Stress Scale (PSS) while cortisol levels were measured in participants' hair. Structural equation modeling tested the effects of cumulative and current stress on cortisol and HRQL. RESULTS Cumulative stress was negatively associated with HRQL (standardized path coefficient = -.51, p < .05). Interestingly, however, cumulative stress was inversely associated with hair cortisol level (standardized path coefficient = -.51, p < .05). Current stress was positively associated with cortisol level (standardized path coefficient = .43, p < .05) and negatively associated with the mental HRQL (standardized path coefficient < -.37, p < .05). CONCLUSION Cumulative stress exhibited a different effect on HPA functioning from current perceived stress. Mental health was significantly impaired by both cumulative and current perceived stress. Implications for mental health nursing practice and research among Arab Americans are discussed.
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Affiliation(s)
- Maha Albdour
- Maha Albdour, PhD, APHN-BC, RN, College of Nursing, Wayne State University, Detroit, MI, USA
| | - Thomas Templin
- Thomas Templin, PhD, College of Nursing, Wayne State University, Detroit, MI, USA
| | - Samuele Zilioli
- Samuele Zilioli, PhD, Department of Family Medicine and Public Health Sciences, Department of Psychology, Wayne State University, Detroit, MI, USA
| | - Jun Sung Hong
- Jun Sung Hong, PhD, School of Social Work, Wayne State University, Detroit, MI, USA
| | - Mark A Lumley
- Mark A. Lumley, PhD, Department of Psychology, Wayne State University, Detroit, MI, USA
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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] [What about the content of this article? (0)] [Affiliation(s)] [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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Martinez RAM, Howard AG, Fernández-Rhodes L, Maselko J, Pence BW, Dhingra R, Galea S, Uddin M, Wildman DE, Aiello AE. Does biological age mediate the relationship between childhood adversity and depression? Insights from the Detroit Neighborhood Health Study. Soc Sci Med 2024; 340:116440. [PMID: 38039767 PMCID: PMC10843850 DOI: 10.1016/j.socscimed.2023.116440] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Abstract] [MESH Headings] [Grants] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 08/07/2023] [Revised: 10/26/2023] [Accepted: 11/15/2023] [Indexed: 12/03/2023]
Abstract
The link between childhood adversity and adulthood depression is well-established; however, the underlying mechanisms are still being explored. Recent research suggests biological age may mediate the relationship between childhood adversity and depression in later life. This study examines if biological age mediates the relationship between childhood adversity and depression symptoms using an expanded set of biological age measures in an urban population-based cohort. Data from waves 1-3 of the Detroit Neighborhood Health Study (DNHS) were used in this analysis. Questions about abuse during childhood were coded to form a childhood adversity score similar to the Adverse Childhood Experience measure. Multiple dimensions of biological age, defined as latent variables, were considered, including systemic biological age (GrimAge, PhenoAge), epigenetic age (Horvath, SkinBlood), and immune age (cytomegalovirus, herpes simplex virus type 1, C-reactive protein, interleukin-6). Depression symptoms, modeled as a latent variable, were captured through the Patient Health Questionnaire-9 (PHQ-9). Models were adjusted for age, gender, race, parent education, and past depressive symptoms. Total and direct effects of childhood adversity on depression symptoms and indirect effects mediated by biological age were estimated. For total and direct effects, we observed a dose-dependent relationship between cumulative childhood adversity and depression symptoms, with emotional abuse being particularly influential. However, contrary to prior studies, in this sample, we found few direct effects of childhood adversity on biological age or biological age on depression symptoms and no evidence of mediation through the measures of biological age considered in this study. Further research is needed to understand how childhood maltreatment experiences are embodied to influence health and wellness.
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Affiliation(s)
- Rae Anne M Martinez
- Department of Epidemiology, Gillings School of Global Public Health, University of North Carolina at Chapel Hill, Chapel Hill, NC, USA; Carolina Population Center, University of North Carolina at Chapel Hill, Chapel Hill, NC, USA.
| | - Annie Green Howard
- Carolina Population Center, University of North Carolina at Chapel Hill, Chapel Hill, NC, USA; Department of Biostatistics, Gillings School of Global Public Health, University of North Carolina at Chapel Hill, Chapel Hill, NC, USA
| | | | - Joanna Maselko
- Department of Epidemiology, Gillings School of Global Public Health, University of North Carolina at Chapel Hill, Chapel Hill, NC, USA; Carolina Population Center, University of North Carolina at Chapel Hill, Chapel Hill, NC, USA
| | - Brian W Pence
- Department of Epidemiology, Gillings School of Global Public Health, University of North Carolina at Chapel Hill, Chapel Hill, NC, USA
| | - Radhika Dhingra
- Department of Environmental Sciences and Engineering, Gillings School of Global Public Health, University of North Carolina at Chapel Hill, Chapel Hill, NC, USA; Brody School of Medicine, East Carolina University, Greenville, NC, USA
| | - Sandro Galea
- Office of the Dean, School of Public Health, Boston University, Boston, USA
| | - Monica Uddin
- Genomics Program, College of Public Health, University of South Florida, Tampa, FL, USA
| | - Derek E Wildman
- Genomics Program, College of Public Health, University of South Florida, Tampa, FL, USA
| | - Allison E Aiello
- Department of Epidemiology, Mailman School of Public Health, Columbia, NY, New York, USA; Robert N. Butler Columbia Aging Center, Columbia, NY, New York, USA
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Folk JB, Ramaiya M, Holloway E, Ramos L, Marshall BDL, Kemp K, Li Y, Bath E, Mitchell DK, Tolou-Shams M. The Association Between Expanded ACEs and Behavioral Health Outcomes Among Youth at First Time Legal System Contact. Res Child Adolesc Psychopathol 2023; 51:1857-1870. [PMID: 36565372 PMCID: PMC10290175 DOI: 10.1007/s10802-022-01009-w] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Abstract] [Key Words] [MESH Headings] [Grants] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Accepted: 12/13/2022] [Indexed: 12/25/2022]
Abstract
A growing body of literature has documented high rates of adverse childhood experiences (ACEs) and their effects on behavioral health among adolescents impacted by the juvenile legal system. Most research with justice-impacted youth assesses the ten standard ACEs, encompassing abuse, neglect, and household dysfunction. This body of work has largely ignored the five expanded ACEs which assess social and community level adversity. Justice-impacted youth commonly experience expanded ACEs (racial discrimination, placement in foster care, living in a disadvantaged neighborhood, witnessing violence, bullying), and inclusion of these adversities may enhance predictive utility of the commonly used ACEs score. The current study examined the prospective impact of total ACEs (standard and expanded) on alcohol and cannabis use, substance-related consequences, and psychiatric symptoms during the year following first ever contact with the juvenile court. Results indicate justice-impacted youth experience multiple expanded ACEs prior to first court contact. The expanded ACEs did not predict any of the behavioral health outcomes assessed, over and above the standard ACEs. Inclusion of expanded ACEs in the standard ACEs score may not increase utility in identifying prospective behavioral health outcomes among youth in first time contact with the juvenile legal system.
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Affiliation(s)
- Johanna B Folk
- Department of Psychiatry and Behavioral Sciences, University of California, San Francisco, San Francisco, CA, USA
| | - Megan Ramaiya
- Department of Psychiatry and Behavioral Sciences, University of California, San Francisco, San Francisco, CA, USA
| | - Evan Holloway
- Department of Psychiatry and Behavioral Sciences, University of California, San Francisco, San Francisco, CA, USA
| | - Lili Ramos
- Department of Psychiatry and Behavioral Sciences, University of California, San Francisco, San Francisco, CA, USA
| | - Brandon D L Marshall
- Department of Epidemiology, Brown University School of Public Health, Providence, RI, USA
| | - Kathleen Kemp
- Department of Psychiatry and Human Behavior, The Warren Alpert Medical School of Brown University, Providence, RI, USA
| | - Yu Li
- Department of Epidemiology, Brown University School of Public Health, Providence, RI, USA
| | - Eraka Bath
- Department of Psychiatry and Biobehavioral Sciences, University of California, Los Angeles, Los Angeles, CA, USA
| | - Daphne Koinis Mitchell
- Department of Psychiatry and Human Behavior, The Warren Alpert Medical School of Brown University, Providence, RI, USA
- Department of Pediatrics, Brown University, Providence, RI, USA
| | - Marina Tolou-Shams
- Department of Psychiatry and Behavioral Sciences, University of California, San Francisco, San Francisco, CA, USA
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7
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Mercer L, Cookson A, Müller-Myhsok B, van Vuuren J. Burnout and secondary traumatic stress in staff working with people with intellectual disabilities: The role of adverse childhood experiences, resilience and trauma-informed organisational climate. J Appl Res Intellect Disabil 2023; 36:1297-1307. [PMID: 37533333 DOI: 10.1111/jar.13148] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Abstract] [Key Words] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 10/29/2022] [Revised: 06/01/2023] [Accepted: 07/17/2023] [Indexed: 08/04/2023]
Abstract
BACKGROUND There has been extensive research into adverse childhood experiences (ACEs), however, less consideration has been given to the prevalence and impact of ACEs for staff working with people with intellectual disabilities. METHOD Participants were staff employed by agencies that care for people with intellectual disabilities. An online survey collected demographic information and measures of ACEs, resilience, trauma-informed organisational climate, burnout and secondary traumatic stress. Correlation, regression, mediation and moderation analyses were used. RESULTS 81.7% of 109 participants had experienced at least one ACE. Burnout, secondary traumatic stress and resilience were greater in the present study than in comparable samples. Trauma-informed organisational climate significantly predicted burnout and secondary traumatic stress. Resilience significantly predicted burnout. CONCLUSIONS Staff working with people with intellectual disabilities are likely to have experienced ACEs. Working in a trauma-informed organisational climate and resilience may be effective avenues for reducing burnout and secondary traumatic stress.
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Affiliation(s)
- Louise Mercer
- Department of Primary Care and Mental Health, University of Liverpool, Liverpool, UK
| | - Alex Cookson
- Learning Disability Community Team, Merseycare NHS Trust, Liverpool, UK
| | | | - Julie van Vuuren
- Department of Primary Care and Mental Health, University of Liverpool, Liverpool, UK
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Zhen-Duan J, Nuñez M, Solomon MB, Geracioti T, Jacquez F. Adverse Childhood Experiences and alcohol use among U.S.-born and immigrant Latinx youth: the roles of social support and stress hormones. J Child Fam Stud 2023; 32:3568-3580. [PMID: 38404361 PMCID: PMC10888520 DOI: 10.1007/s10826-023-02550-y] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Abstract] [Key Words] [Grants] [Track Full Text] [Subscribe] [Scholar Register] [Accepted: 02/06/2023] [Indexed: 02/27/2024]
Abstract
The biobehavioral correlates of Adverse Childhood Experiences (ACEs) among Latinx youth have been strikingly understudied. The purpose of this study was to 1) examine the effects of T-ACEs (e.g., maltreatment, family dysfunction) and E-ACEs (e.g., family deportation, community violence) in alcohol use, 2) test whether social support moderated these associations and 3) explore whether ACEs and alcohol use were related via adrenocortical hormones (i.e., cortisol, dehydroepiandrosterone [DHEA]). A total of 100 Latinx youth, between the ages of 13 and 19, participated in this study (53% female). Community samples of United States (U.S.)-born (N = 54) and immigrant Latinx (N = 46) youth provided morning saliva samples and completed self-report questionnaires. Results highlighted that for immigrant youth, social support buffered the effects of E-ACEs on alcohol use, F(9,89)= 3.34, p = .01, R2 = .25. Although our mediation hypothesis was not supported, the direct effects of T-ACEs (β = .25, t (94) = 2.21, p = .03) and E-ACES (β = -.24, t (94) = -2.23, p = .03) on DHEA were significant for the entire sample. Preventing maltreatment and reducing community-level adversities seem critical for optimal child development, as exposure to these may increase alcohol use risk and affect HPA Axis functioning. Increasing extrafamilial support may be particularly salient for immigrant Latinx youth, as many experience extended immigration-related periods of separation from family members.
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Affiliation(s)
- Jenny Zhen-Duan
- Disparities Research Unit, Department of Medicine, Massachusetts General Hospital, 50 Staniford Street Suite 830 Boston, MA 02114 United States
- Department of Psychiatry, Harvard Medical School, 401 Park Drive Boston, MA 02215 United States
| | - Miguel Nuñez
- Department of Psychology, University of Cincinnati, 66 Corry Blvd, Cincinnati, OH 45219 United States
| | - Matia B. Solomon
- Department of Psychology, University of Cincinnati, 66 Corry Blvd, Cincinnati, OH 45219 United States
| | - Thomas Geracioti
- Department of Psychiatry and Behavioral Neurosciences, University of Cincinnati College of Medicine, 2631 Erie Ave, Suite 3, Cincinnati, Ohio 45208 United States
| | - Farrah Jacquez
- Department of Psychology, University of Cincinnati, 66 Corry Blvd, Cincinnati, OH 45219 United States
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Litke SG, Resnikoff A, Anil A, Montgomery M, Matta R, Huh-Yoo J, Daly BP. Mobile Technologies for Supporting Mental Health in Youths: Scoping Review of Effectiveness, Limitations, and Inclusivity. JMIR Ment Health 2023; 10:e46949. [PMID: 37610818 PMCID: PMC10467602 DOI: 10.2196/46949] [Citation(s) in RCA: 1] [Impact Index Per Article: 1.0] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Abstract] [Key Words] [Track Full Text] [Journal Information] [Submit a Manuscript] [Subscribe] [Scholar Register] [Received: 03/02/2023] [Revised: 07/01/2023] [Accepted: 07/07/2023] [Indexed: 08/24/2023] Open
Abstract
BACKGROUND Over the past decade, there has been growing support for the use of mobile health (mHealth) technologies to improve the availability of mental health interventions. While mHealth is a promising tool for improving access to interventions, research on the effectiveness and efficacy of mHealth apps for youths is limited, particularly for underrepresented populations, including youths of color and economically marginalized youths. OBJECTIVE This scoping review study sought to evaluate the following research questions: (1) What is the extent of the current literature on mHealth apps that provide intervention for mental health problems in children and adolescents? (2) What is known from the existing literature about the effectiveness or efficacy of delivering mental health services via mHealth apps? (3) What are the gaps in the knowledge base in the fields of technology and mental health? (4) Do the reviewed mHealth apps address issues of cultural sensitivity or have they been tested with underrepresented groups (ie, youths of color or economically marginalized groups)? METHODS An electronic database search was conducted using relevant search terms. Seven independent reviewers screened identified studies, including title and abstract review to determine if studies met the following inclusion criteria: (1) targeted samples with mental health symptomology or disorders, (2) studied youth participants aged 6-17 years, and (3) examined the use of a mobile app-based platform for intervention. Relevant studies were subjected to full-text review to extract and chart relevant data based on a priori research questions. RESULTS The initial database search yielded 304 papers published from 2010 to 2021. After screening and selection, the final review included 10 papers on the effectiveness and efficacy of mental health intervention apps for youths aged 8 to 17 years. Identified apps targeted a broad range of mental health challenges in youths (ie, depression, self-harm, autism spectrum disorder, anxiety, and obsessive-compulsive disorder). Results identified only a small number of studies suggesting that current effectiveness and efficacy research in this area are limited. While some studies provided general support for the effectiveness of mHealth apps in improving mental health outcomes in youths, several notable limitations were present across the literature, reducing the generalizability of findings. Additionally, considerations around racial, ethnic, and socioeconomic diversity were scarce across studies. CONCLUSIONS Although some studies cited in this scoping review provide support for the effectiveness and efficacy of mHealth apps targeting mental health concerns in youths, the overall body of literature remains quite limited. Moreover, mHealth apps expressly developed to be culturally responsive are almost nonexistent. Further efforts are needed to recruit youths who are typically underrepresented in research and invite stakeholder participation and collaborative input in the early stages of the mHealth app development process.
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Affiliation(s)
- Shannon Grace Litke
- Department of Psychological and Brain Sciences, Drexel University, Philadelphia, PA, United States
| | - Annie Resnikoff
- Department of Psychological and Brain Sciences, Drexel University, Philadelphia, PA, United States
| | - Ashley Anil
- Department of Psychological and Brain Sciences, Drexel University, Philadelphia, PA, United States
| | - Meredith Montgomery
- Department of Information Science, Drexel University, Philadelphia, PA, United States
| | - Rishabh Matta
- Department of Information Science, Drexel University, Philadelphia, PA, United States
| | - Jina Huh-Yoo
- Department of Information Science, Drexel University, Philadelphia, PA, United States
| | - Brian P Daly
- Department of Psychological and Brain Sciences, Drexel University, Philadelphia, PA, United States
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10
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Zhen-Duan J, Colombo D, Alvarez K. Inclusion of Expanded Adverse Childhood Experiences in Research About Racial/Ethnic Substance Use Disparities. Am J Public Health 2023; 113:S129-S132. [PMID: 37339415 PMCID: PMC10282858 DOI: 10.2105/ajph.2023.307220] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [MESH Headings] [Grants] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Accepted: 01/02/2022] [Indexed: 06/22/2023]
Affiliation(s)
- Jenny Zhen-Duan
- Jenny Zhen-Duan is with the Departments of Psychiatry and Medicine, Massachusetts General Hospital, and the Department of Psychiatry, Harvard Medical School, Boston, MA. Daniella Colombo is with Rutgers New Jersey Medical School, Newark, NJ. Kiara Alvarez is with the Johns Hopkins Bloomberg School of Public Health, Baltimore, MD
| | - Daniella Colombo
- Jenny Zhen-Duan is with the Departments of Psychiatry and Medicine, Massachusetts General Hospital, and the Department of Psychiatry, Harvard Medical School, Boston, MA. Daniella Colombo is with Rutgers New Jersey Medical School, Newark, NJ. Kiara Alvarez is with the Johns Hopkins Bloomberg School of Public Health, Baltimore, MD
| | - Kiara Alvarez
- Jenny Zhen-Duan is with the Departments of Psychiatry and Medicine, Massachusetts General Hospital, and the Department of Psychiatry, Harvard Medical School, Boston, MA. Daniella Colombo is with Rutgers New Jersey Medical School, Newark, NJ. Kiara Alvarez is with the Johns Hopkins Bloomberg School of Public Health, Baltimore, MD
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11
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Abdelhamid S, Lindert J, Fischer J, Steinisch M. Negative and protective experiences influencing the well-being of refugee children resettling in Germany: a qualitative study. BMJ Open 2023; 13:e067332. [PMID: 37076150 PMCID: PMC10124287 DOI: 10.1136/bmjopen-2022-067332] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Abstract] [Key Words] [Track Full Text] [Journal Information] [Submit a Manuscript] [Subscribe] [Scholar Register] [Indexed: 04/21/2023] Open
Abstract
OBJECTIVE Conflict, forced migration and searching for safety in a foreign land are all experiences common to refugee children. They experience potentially traumatic events that are distinct from the general population, yet current adverse childhood experience (ACE) studies do not cover these events. Studies that do examine refugee children's experiences typically focus on a single stage of migration or adversities from the community, offering insight into only a fraction of their realities. This study aimed to identify potentially traumatising and protective experiences subjectively perceived as influencing refugee children's well-being from all stages of migration and all socio-ecological levels. DESIGN Qualitative study with thematic analysis of semi-structured individual and group interviews. Themes were organised within a socio-ecological model. SETTING Non-profit organisations, youth welfare facilities and societies that organise civic engagement for refugee families in the Rhine-Neckar region in Germany provided rooms where interviews could be conducted. PARTICIPANTS Refugee parents and children who spoke one of the four most common languages of those seeking asylum in Germany in 2018 were included. This study excluded refugees who were not fleeing a conflict area. Forty-seven refugee parents and 11 children (aged 8-17 years) from Syria, Iraq, Palestine, Afghanistan and Eritrea participated. RESULTS Eight major themes emerged from interviews including six reflecting potentially negative experiences and two potentially protective themes. These themes evolved from experiences such as family dispersion, displacement, rigorous immigration and national policies, as well as constructive parenting and community support. CONCLUSION It is increasingly important to identify these diverse experiences as the refugee population continues to grow, and the increased prevalence of poor health outcomes in refugee children continues to be widely documented. Identifying ACEs specifically relevant to refugee children could contribute to understanding potential pathways and could further serve as a starting point for tailored interventions.
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Affiliation(s)
- Shaymaa Abdelhamid
- Medical Faculty Mannheim, Center for Preventive Medicine and Digital Health (CPD), Division of General Medicine, Heidelberg University, Heidelberg, Germany
| | - Jutta Lindert
- Department of Social Work and Health, University of Applied Sciences Emden/Leer, Emden, Germany
| | - Joachim Fischer
- Medical Faculty Mannheim, Center for Preventive Medicine and Digital Health (CPD), Division of General Medicine, Heidelberg University, Heidelberg, Germany
| | - Maria Steinisch
- Medical Faculty Mannheim, Center for Preventive Medicine and Digital Health (CPD), Division of Public Health, Social and Preventive Medicine, Heidelberg University, Heidelberg, Germany
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Sosnowski DW, Rojo-Wissar DM, Smail EJ, Musci RJ, Wilcox HC, Johnson SB. Expanding on Threat and Deprivation: Empirical Examination of Adversity Dimensions and Psychiatric Outcomes Among Emerging Adults. Emerg Adulthood 2023; 11:431-443. [PMID: 36969950 PMCID: PMC10038124 DOI: 10.1177/21676968221114260] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Abstract] [Key Words] [Grants] [Track Full Text] [Subscribe] [Scholar Register] [Indexed: 05/06/2023]
Abstract
Dimensional models of adversity, whereby experiences lie along dimensions of threat and deprivation, are increasingly popular; however, their empirical validation is limited. In a sample of emerging adults (N=1,662; M age =20.72; 53% female; 72% Black), we conducted exploratory factor analyses using adversities derived from items probing family relationships and a validated assessment of traumatic events. Resulting factors were used to test associations with odds of lifetime diagnosis of a substance use disorder, other mental health disorders, and suicide attempt. Results supported a four-factor solution: threat (non-betrayal), emotional deprivation, sexual assault, and threat (betrayal). Threat (betrayal) summary scores were most strongly associated with increased odds of substance use and other disorders, whereas sexual assault was most strongly associated increased odds of lifetime suicide attempt. Findings provide some empirical support for categorizing adversity along dimensions of threat and deprivation. However, it also suggests the possibility of further divisions within these dimensions.
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Affiliation(s)
- David W Sosnowski
- Department of Mental Health, Johns Hopkins Bloomberg School of Public Health
| | | | - Emily J Smail
- Department of Mental Health, Johns Hopkins Bloomberg School of Public Health
| | - Rashelle J Musci
- Department of Mental Health, Johns Hopkins Bloomberg School of Public Health
| | - Holly C Wilcox
- Department of Mental Health, Johns Hopkins Bloomberg School of Public Health
| | - Sara B Johnson
- Department of Mental Health, Johns Hopkins Bloomberg School of Public Health
- Department of Pediatrics, School of Medicine, Johns Hopkins University
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13
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Kil H, Longpré C, Mageau GA. Dysregulation profile in children of ethnoracially diverse at-risk families: Factor structure and longitudinal correlates. Dev Psychopathol 2023:1-12. [PMID: 36847250 PMCID: PMC10464460 DOI: 10.1017/s095457942300007x] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Abstract] [Key Words] [Grants] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 03/01/2023]
Abstract
The present work sought to confirm the factor structure and examine longitudinal strengths-based and mental health correlates of the dysregulation profile (DP) in children of at-risk fragile families of diverse ethnoracial backgrounds. The data came from the Fragile Families and Child Wellbeing Study (N = 2125 families). Mothers (Mage = 25.3) were mostly unmarried (74.6%), and children (51.4% boys) were identified as Black (47.0%), Hispanic (21.4%), White (16.7%), or multiracial or other backgrounds. Childhood DP was constructed using mother reports of the Child Behavior Checklist at age 9. Mothers' in-home parent-child interactions and depressive symptoms were assessed at child age 5. At age 15, children responded about their own mental health, social skills, and other strengths-focused outcomes. A bifactor DP structure fit well to the data, with the DP factor representing difficulties in self-regulation. Using SEM, we found that mothers who were more depressed and used less warm parenting at child age 5 had children who presented with higher DP at age 9. DP was in turn associated with less social skills, perseverance, optimism, and more anxiety, depression, and impulsivity at adolescence. Childhood DP appears to be relevant and applicable for at-risk, diverse families, and may also impede on children's future positive functioning.
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Affiliation(s)
- Hali Kil
- Department of Psychology, Simon Fraser University, Burnaby, Canada
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14
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Abstract
Adverse childhood experiences (ACEs) are concerning exposures that may have detrimental effects on mental health. Much of the prior evidence on ACEs comes from the U.S and western developed countries. In light of the limited knowledge of ACEs in other social contexts and the interconnection among adversities, this study aims to identify distinct patterns of co-occurring ACEs and examines the associations between those adversities and mental health in South Korea. We used data from a national sample of Korean college students recruited via non-probability quota sampling in 2019 (N = 1037). The dependent variables included three measures of mental health assessed by the Brief Symptom Inventory depression symptoms, anxiety symptoms, and somatization symptoms. The independent variable was the patterns of ACEs identified using 14 indicators of childhood adversity. We conducted a Latent Class Analysis with a distal outcome, using the Bolck, Croons, and Hagenaars method. The analysis found four patterns of ACEs: extreme adversity (8%), family violence (20.3%), economic adversity (10.4%), and low adversity (61.3%). The extreme adversity group exhibited multiple exposures, including interpersonal violence in home environments, economic hardship, and bullying victimization by peers. The results suggest that the extreme adversity and family violence groups showed significantly worse mental health symptoms than the economic adversity and low adversity groups. Also, the extreme adversity group reported significantly higher levels of depression symptoms and somatization symptoms than the family violence group. This study expands the current understanding of ACEs and their harmful effects on mental health in young adulthood specific to Korea while comparing them with other social contexts. Researchers and practitioners should recognize the co-occurrence of child adversities, rather than overestimating sole adversity, to develop effective strategies for promoting mental health.
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Affiliation(s)
- Youngmi Kim
- School of Social Work, 6889Virginia Commonwealth University, Richmond, VA, USA
| | - Aely Park
- Department of Social Welfare, 65380Sunchon National University, Suncheon, South Korea
| | - Jennifer Murphy
- School of Social Work, 6889Virginia Commonwealth University, Richmond, VA, USA
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15
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Gitterman DP, Hay WW, Langford WS. The NIH childhood adversity portfolio: unmet needs, emerging challenges. Pediatr Res 2023:10.1038/s41390-022-02440-x. [PMID: 36631692 DOI: 10.1038/s41390-022-02440-x] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Abstract] [Track Full Text] [Journal Information] [Submit a Manuscript] [Subscribe] [Scholar Register] [Received: 11/29/2022] [Accepted: 12/05/2022] [Indexed: 01/13/2023]
Abstract
Despite the significant increase in pediatric funding, an important question is whether recent changes in the burden of disease and conditions (child and adolescent mortality and nonfatal health loss) are reflected in the National Institutes of Health's (NIH) allocation process. As it sets future priorities, NIH acknowledges "a need to scan the landscape for unmet needs and emerging challenges" so that supported "research translates into meaningful health benefits." Our focus is to scan the pediatric budgetary landscape, report research funding for childhood adversity and adverse childhood experiences, and to illuminate gun violence, suicide, and drug abuse/overdose as prime examples of pediatric unmet needs and emerging challenges. Our findings suggest that pediatric researchers must reconceptualize gun violence as a form of childhood adversity and adverse childhood experiences, as we also need to do for other leading causes of child and adolescent mortality such as suicide and drug abuse/overdose. As it relates to the leading cause of death for children and adolescents, pediatric-related gun violence research spending remains only 0.0017% of the NIH pediatric portfolio. IMPACT: New data on NIH spending on ACEs and childhood adversity. New data to assess the relationship of spending to pediatric burden of disease. New data on pediatrics-related gun violence, suicide and drug abuse/overdose spending.
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Affiliation(s)
- Daniel P Gitterman
- Duncan MacRae'09 and Rebecca Kyle MacRae Professor of Public Policy, University of North Carolina at Chapel Hill, CB #3435, Chapel Hill, NC, 27516, USA.
| | - William W Hay
- Retired Professor, University of Colorado, 401 Hudson Street, Denver, CO, 80220-5239, USA
| | - W Scott Langford
- Postdoc, Arizona State University, 411 N. Central Avenue, Ste. 450, Phoenix, AZ, 85004-0687, USA
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16
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Purtle J, Bowler S, Boughter-Dornfeld M, Nelson KL, Gollust SE. Newspaper Coverage of Adverse Childhood Experiences and Toxic Stress in the United States, 2014-2020: Consequences, Causes, and Solutions. Trauma Violence Abuse 2023; 24:313-323. [PMID: 34269132 DOI: 10.1177/15248380211029407] [Citation(s) in RCA: 1] [Impact Index Per Article: 1.0] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Abstract] [Key Words] [MESH Headings] [Track Full Text] [Subscribe] [Scholar Register] [Indexed: 06/13/2023]
Abstract
News media can shape public opinion about child adversity and influence the translation of research into public policy. Research about adverse childhood experiences (ACEs) and toxic stress has increased dramatically in recent years, but little is known about how these concepts are covered in news media. We reviewed how newspapers in the United States have portrayed the consequences of, causes of, and solutions to address ACEs and toxic stress, examined trends in newspaper coverage, and assessed differences in coverage of ACEs versus toxic stress. Quantitative content analysis was conducted of 746 newspaper articles mentioning "adverse childhood experience(s)" and/or "toxic stress" published in 25 U.S. newspapers between January 1, 2014, and May 30, 2020. κ statistics of interrater reliability were calculated, and variables with κ ≥ .60 were retained for quantitative analysis. We found that newspaper coverage of ACEs and toxic stress increased dramatically between 2014 and 2018 and then sharply declined. Only 13.3% of articles mentioned both ACEs and toxic stress. There were many statistically significant (p < .05) differences in the causes, consequences, and solutions identified in articles focused on ACEs versus toxic stress. Coverage of both concepts predominantly focused on consequences for individuals, not society. However, 54.6% of articles identified a structural cause of ACEs and/or toxic stress. Increased volume in newspaper coverage about ACEs and toxic stress could increase public awareness about the relationship between childhood adversity and adult outcomes. There is a need to portray ACEs and toxic stress as complementary concepts more coherently in news media.
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Affiliation(s)
- Jonathan Purtle
- Department of Health Management and Policy, Dornsife School of Public Health, 6527Drexel University, Philadelphia, PA, USA
| | - Sarah Bowler
- Department of Health Services Administration, School of Health Professions, University of Alabama at Birmingham, AL, USA
| | - Maura Boughter-Dornfeld
- Department of Health Management and Policy, Dornsife School of Public Health, 6527Drexel University, Philadelphia, PA, USA
| | - Katherine L Nelson
- Department of Health Management and Policy, Dornsife School of Public Health, 6527Drexel University, Philadelphia, PA, USA
| | - Sarah E Gollust
- Division of Health Policy and Management, 43353University of Minnesota School of Public Health, Minneapolis, MN, USA
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17
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Long D, Hessler D, Koita K, Bucci M, Benson M, Gilgoff R, Thakur N, Burke Harris N. Screening for adverse childhood experiences in pediatrics: A randomized trial of aggregate-level versus item-level response screening formats. PLoS One 2022; 17:e0273491. [PMID: 36520927 PMCID: PMC9754205 DOI: 10.1371/journal.pone.0273491] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Abstract] [MESH Headings] [Grants] [Track Full Text] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Received: 04/27/2021] [Accepted: 08/05/2022] [Indexed: 12/23/2022] Open
Abstract
BACKGROUND While there is growing support for screening for Adverse Childhood Experiences (ACEs), rigorous evidence on the efficacy and preference of screening methods is needed. OBJECTIVE To examine caregiver: (1) rates of disclosure of their child's exposure to ACEs using item-level response (each item can be endorsed) versus aggregate-level response (only total score reported) screening format, (2) associations between family demographic factors and disclosure by screening format, and (3) emotional reaction and experience of screening formats in a diverse, low-income pediatric population. METHODS Caregiver participants (n = 367) were randomized to complete the Pediatric ACEs and Related Life Events Screener (PEARLS) tool, in an aggregate-level response vs item-level response format from 2016-2019. Select caregivers (n = 182) participated in debriefing interviews. T-test and chi-square analyses in 2019 compared PEARLS disclosure rates and reactions between the screening modalities. Regression models explored interactions with child characteristics. Thematic analysis of interview notes captured caregiver screening experience. RESULTS PEARLS disclosure rates were significantly higher in the aggregate-level response compared to the item-level response screening arm (p <0.05). This difference was accentuated for children identified as black and/or male (p <0.05). Caregiver reactions to PEARLS screening were rarely negative in either screening format. Qualitative data demonstrated strong caregiver preference for the item-level response format; additional themes include provider relationship, fear with disclosure, and screening outcome expectations. CONCLUSION While caregivers reported a preference for the item-level response format, the aggregate-level response screening format elicited higher disclosures rates particularly for children who are black or ma. TRIAL REGISTRATION Clinical trial registry: NCT04182906.
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Affiliation(s)
- Dayna Long
- Center for Child and Community Health, Benioff Children’s Hospital Oakland, University of California, San Francisco, San Francisco, California, United States of America
| | - Danielle Hessler
- Department of Medicine and Family and Community Medicine, University of California, San Francisco, San Francisco, California, United States of America
- * E-mail:
| | - Kadiatou Koita
- Center for Youth Wellness, San Francisco, California, United States of America
| | - Monica Bucci
- Center for Youth Wellness, San Francisco, California, United States of America
| | - Mindy Benson
- Center for Child and Community Health, Benioff Children’s Hospital Oakland, University of California, San Francisco, San Francisco, California, United States of America
| | - Rachel Gilgoff
- Center for Youth Wellness, San Francisco, California, United States of America
| | - Neeta Thakur
- Department of Medicine and Family and Community Medicine, University of California, San Francisco, San Francisco, California, United States of America
| | - Nadine Burke Harris
- Center for Youth Wellness, San Francisco, California, United States of America
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18
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Keane K, Evans RR. Exploring the Relationship Between Modifiable Protective Factors and Mental Health Issues Among Children Experiencing Adverse Childhood Experiences Using a Resilience Framework. J Child Adolesc Trauma 2022; 15:987-998. [PMID: 36439658 PMCID: PMC9684361 DOI: 10.1007/s40653-022-00471-4] [Citation(s) in RCA: 1] [Impact Index Per Article: 0.5] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Abstract] [Key Words] [Track Full Text] [Subscribe] [Scholar Register] [Accepted: 07/04/2022] [Indexed: 06/16/2023]
Abstract
The purpose of this study was to examine whether the National Scientific Council on the Developing Child (NSCDC) resilience framework statistically predicted whether a child with 4 or more adverse childhood experiences (ACEs) ever had a mental health issue. The study also explored which NSCDC modifiable resilience factors had the strongest relationship with mental health issues among children with 4 or more ACEs. Utilizing the 2019 National Survey of Children's Health, secondary data analysis was conducted using a sample of 1,225 children between 6 and 17 years old that had experienced 4 or more ACEs. Logistic regression examined whether the NSCDC framework was associated with a lower likelihood of mental health issues in school-aged children. Analysis found that the NSCDC framework predicted whether children with 4 or more ACEs ever had a mental health issue. Self-regulation had the strongest relationship with whether a child with 4 or more ACEs ever had a mental health issue. A supportive parent/caregiver relationship was also associated with a lower likelihood of ever having a mental health issue. The results demonstrate the promise of the NSCDC framework and modifiable protective factors to mitigate the impact of ACEs on mental health outcomes. Interventions that teach children skill-based self-regulation and parent/caregiver co-regulation while providing safe and supportive environments can build self-regulation to overcome ACEs. Promoting resilience-building parent-child relationships also have the potential to build resilience to mitigate ACEs.
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Affiliation(s)
- Kevin Keane
- University of Alabama at Birmingham, 1720 2nd Avenue South, NB 202, Birmingham, AL 35294-1210 USA
| | - Retta R. Evans
- University of Alabama at Birmingham, 1150 10th Avenue South, EEC 301C, Birmingham, AL 35294-1250 USA
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19
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Rankine J, Fuhrman B, Copperman E, Miller E, Culyba A. School Absenteeism Among Middle School Students With High Exposure to Violence. Acad Pediatr 2022; 22:1300-1308. [PMID: 35342032 PMCID: PMC9509495 DOI: 10.1016/j.acap.2022.03.012] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Abstract] [Key Words] [MESH Headings] [Grants] [Track Full Text] [Journal Information] [Submit a Manuscript] [Subscribe] [Scholar Register] [Received: 12/01/2021] [Revised: 03/16/2022] [Accepted: 03/19/2022] [Indexed: 01/18/2023]
Abstract
OBJECTIVE Chronic school absenteeism is linked to failure to graduate high school and poor health in adulthood. Contextual factors associated with absenteeism may be under-recognized in school and clinical settings. We examined the prevalence of self-reported absenteeism and violence exposure and their association among middle school students with identified risk of trauma. METHODS We analyzed baseline data from a dating violence prevention program. Participants completed surveys identifying lifetime exposure to 10 types of violence and past 30-day absence. Violence exposure and absenteeism were summarized and compared across demographic groups. Generalized linear models examined associations between 1) any history of violence exposure, 2) each type of violence exposure, and 3) summed exposures to different types of violence, and frequent absenteeism (≥2 absences in past 30 days). RESULTS Of all participants (overall n = 499), 45.5% reported frequent absenteeism and 71.5% reported violence exposure. Any self-reported violence exposure was associated with absenteeism (aRR = 1.43, 95%CI: 1.06-1.92). However, no specific type of violence exposure predicted absenteeism. Comparing summed exposures to different types of violence to no violence exposure, exposure to 1 type of violence was associated with absenteeism (aRR = 1.59, 95%CI: 1.15-2.20), with no evidence of stronger associations with greater exposure (2-3 types: aRR = 1.37, 95%CI: 1.00-1.88; ≥4 types: aRR = 1.31, 95%CI: 0.98-1.74). CONCLUSIONS Youth in this sample reported both high rates of violence exposure and absenteeism. Prior violence exposure was associated with absenteeism. Resources and contextual support for youth exposed to family or community violence may play a role in school attendance, emphasizing need for trauma-sensitive approaches to absenteeism.
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Affiliation(s)
- Jacquelin Rankine
- UPMC Children's Hospital of Pittsburgh, University of Pittsburgh School of Medicine, 120 Lytton Avenue, Pittsburgh, Pa.
| | - Barbara Fuhrman
- UPMC Children's Hospital of Pittsburgh, University of Pittsburgh School of Medicine, 120 Lytton Avenue, Pittsburgh, Pa
| | - Ethan Copperman
- UPMC Children's Hospital of Pittsburgh, University of Pittsburgh School of Medicine, 120 Lytton Avenue, Pittsburgh, Pa
| | - Elizabeth Miller
- UPMC Children's Hospital of Pittsburgh, University of Pittsburgh School of Medicine, 120 Lytton Avenue, Pittsburgh, Pa
| | - Alison Culyba
- UPMC Children's Hospital of Pittsburgh, University of Pittsburgh School of Medicine, 120 Lytton Avenue, Pittsburgh, Pa
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20
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Morizio LJ, Cook AL, Collier-Meek MA, Famolare GM, Fallon LM, Bender SL. Creating Compassion: Creatively-Focused Explicit Behavioral Instruction for Empathy Development. School Psychology Review 2022. [DOI: 10.1080/2372966x.2022.2109060] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 10/14/2022]
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21
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Cuda S, Censani M, Kharofa R, Williams DR, O'Hara V, Karjoo S, Paisley J, Browne NT. Social consequences and genetics for the child with overweight and obesity: An obesity medicine association (OMA) clinical practice statement 2022. Obes Pillars 2022; 3:100032. [PMID: 37990726 PMCID: PMC10662046 DOI: 10.1016/j.obpill.2022.100032] [Citation(s) in RCA: 2] [Impact Index Per Article: 1.0] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Abstract] [Key Words] [Track Full Text] [Subscribe] [Scholar Register] [Received: 08/01/2022] [Accepted: 08/02/2022] [Indexed: 11/23/2023]
Abstract
Background This Obesity Medicine Association (OMA) clinical practice statement (CPS) covers two topics: 1) genetics and 2) social consequences for the child with overweight and obesity. This CPS is intended to provide clinicians with an overview of clinical practices applicable to children and adolescents with body mass indices greater than or equal to the 85th percentile for their ages, particularly those with adverse consequences resulting from increased body mass. The information in this CPS is based on scientific evidence, supported by the medical literature, and derived from the clinical experiences of members of the OMA. Methods The scientific information and clinical guidance in this CPS is based upon referenced evidence and derived from the clinical perspectives of the authors. Results This OMA clinical practice statement details two topics: 1) genetics and 2) social consequences for the child with overweight and obesity. Conclusions This OMA clinical practice statement on genetics and social consequences for the child with overweight and obesity is an overview of current literature. The literature provides a roadmap to the improvement of the health of children and adolescents with obesity, especially those with metabolic, physiological, and psychological complications.
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Affiliation(s)
- Suzanne Cuda
- Alamo City Healthy Kids and Families, 1919 Oakwell Farms Parkway, Ste 145 San Antonio, TX, 78218, USA
| | - Marisa Censani
- Associate Professor of Clinical Pediatrics, Division of Pediatric Endocrinology, Department of Pediatrics, New York Presbyterian Hospital, Weill Cornell Medicine, 525 East 68th Street, Box 103, New York, NY, 10021, USA
| | - Roohi Kharofa
- Center for Better Health & Nutrition, The Heart Institute, Cincinnati Children's Hospital Medical Center, 3333 Burnet Avenue, Cincinnati, OH, 45229, USA
| | - Dominique R. Williams
- The Ohio State University College of MedicineCenter for Healthy Weight and Nutrition, Nationwide Children's Hospital 700 Children's Drive LA, Suite 5F Columbus, OH, 43215, USA
| | - Valerie O'Hara
- Medical Director, WOW 4 Wellness Clinic/ PCHC, 6 Telcom Drive, Bangor, ME, 04401, USA
| | - Sara Karjoo
- Johns Hopkins All Children's Hospital Pediatric Gastroenterology, 501 6th Ave S, St. Petersburg, FL, 33701, USA
| | - Jennifer Paisley
- St Elizabeth Physician's Group Primary Care 98 Elm Street Lawrenceburg, IN, 47025-2048, USA
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22
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Anand P, Wilson J, Carter B, Bronstein A, Schwartz A, Harrington B, Adams T, Saine ME, Norris A, Metzger D, Short WR, Torgersen J. Clinic screening for adverse childhood experiences in people living with HIV to Improve Care Delivery. AIDS Care 2022; 34:1094-1102. [PMID: 34292107 DOI: 10.1080/09540121.2021.1956416] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Abstract] [Key Words] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 01/26/2023]
Abstract
Adverse childhood experiences (ACEs) are associated with negative health outcomes; however, screening for ACEs is not routinely performed among people living with HIV (PLWH). We conducted a single-center, cross-sectional pilot study to define the (1) prevalence of ACEs in PLWH and (2) acceptability of ACEs screening in routine out-patient clinical care. One hundred participants completed screening: median age of participants was 49 years (interquartile range: 38.5-59.5), 73% male, 66% Non-Hispanic Black/African American, and 47% gay/lesbian. Clinically significant ACEs score, defined as ≥4, was reported in 51%. High ACEs score was more common among participants <50 years old (64.7% vs. 36.7%; p < 0.01), but the prevalence of ACEs ≥4 did not differ by gender, race, ethnicity, or sexual orientation. Among participants with ≥4 ACEs, 44.4% screened negative on both PHQ-9 and PC-PTSD screens. The majority of participants (89%) reported a positive experience with ACEs screening. The prevalence of clinically significant ACEs in this clinic population of PLWH was more than twice that reported in the general population. Routine ACEs screening can improve delivery of trauma-informed care in the HIV primary care setting.
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Affiliation(s)
- Priyanka Anand
- University of Pennsylvania Perelman School of Medicine, Philadelphia, PA, USA
| | - Jennifer Wilson
- University of Pennsylvania School of Nursing, Philadelphia, PA, USA
| | - Bryce Carter
- Penn Medicine, Penn Presbyterian Medical Center, University of Pennsylvania Health Systems, Philadelphia, PA, USA
| | - Abby Bronstein
- Penn Medicine, Penn Presbyterian Medical Center, University of Pennsylvania Health Systems, Philadelphia, PA, USA
| | - Alexis Schwartz
- Penn Medicine, Penn Presbyterian Medical Center, University of Pennsylvania Health Systems, Philadelphia, PA, USA
| | | | - Tracey Adams
- Penn Medicine, Penn Presbyterian Medical Center, University of Pennsylvania Health Systems, Philadelphia, PA, USA
| | - M Elle Saine
- University of Pennsylvania Perelman School of Medicine, Philadelphia, PA, USA
| | - Anne Norris
- Division of Infectious Diseases, Department of Medicine, University of Pennsylvania Perelman School of Medicine, Philadelphia, PA, USA
| | - David Metzger
- Department of Psychiatry, University of Pennsylvania Perelman School of Medicine, Philadelphia, PA, USA
| | - William R Short
- University of Pennsylvania School of Nursing, Philadelphia, PA, USA.,Division of Infectious Diseases, Department of Medicine, University of Pennsylvania Perelman School of Medicine, Philadelphia, PA, USA
| | - Jessie Torgersen
- University of Pennsylvania School of Nursing, Philadelphia, PA, USA.,Division of Infectious Diseases, Department of Medicine, University of Pennsylvania Perelman School of Medicine, Philadelphia, PA, USA
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23
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Koslouski JB, Skubel A, Zaff JF, Porche MV. “My Story Started When I was Younger. . .”: A Qualitative Analysis of Youth’s Differential Journeys Away From School. Journal of Adolescent Research 2022. [DOI: 10.1177/07435584221115893] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Abstract] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 11/16/2022]
Abstract
Adverse childhood experiences (ACEs) increase youths’ risk for leaving high school before graduating. However, to our knowledge, no one has examined how youth themselves conceptualize the role of ACEs in their journeys away from school. In this exploratory qualitative study, we used narrative analysis to examine (1) whether youth (n = 27) described ACEs leading them away from school, (2) how early these trajectories began, from youth’s own perspectives, and (3) if this varied by elements of identity and social position. Focus groups were conducted with youth ages 18-25 from 13 communities across the U.S. We found that youth described their journeys away from school as starting with early ACEs. We also found that youths’ narratives reflected intersectional gender differences in the pathways away from school that youth described. Girls articulated how ACEs influenced subsequent non-academic priorities; they eventually left or were kicked out due to a lack of credits. Boys expressed that early ACEs were followed by risk behaviors, punishment, and dropout. Implications for healing-centered engagement across settings and targeted dropout prevention are discussed.
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24
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Shah AN, Rasnick E, Bhuiyan MA, Wolfe C, Bosse D, Simmons JM, Shah SS, Brokamp C, Beck AF. Using Geomarkers and Sociodemographics to Inform Assessment of Caregiver Adversity and Resilience. Hosp Pediatr 2022; 12:689-695. [PMID: 35909177 DOI: 10.1542/hpeds.2021-006121] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Abstract] [MESH Headings] [Grants] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 06/15/2023]
Abstract
BACKGROUND AND OBJECTIVES A high level of caregiver adverse childhood experiences (ACEs) and/or low resilience is associated with poor outcomes for both caregivers and their children after hospital discharge. It is unknown if sociodemographic or area-based measures (ie, "geomarkers") can inform the assessment of caregiver ACEs or resilience. Our objective was to determine if caregiver ACEs or resilience can be identified by using any combinations of sociodemographic measures, geomarkers, and/or caregiver-reported household characteristics. METHODS Eligible participants for this cohort study were English-speaking caregivers of children hospitalized on a hospital medicine team. Caregivers completed the ACE questionnaire, Brief Resilience Scale, and strain surveys. Exposures included sociodemographic characteristics available in the electronic health record (EHR), geomarkers tied to a patient's geocoded home address, and household characteristics that are not present in the EHR (eg, income). Primary outcomes were a high caregiver ACE score (≥4) and/or a low BRS Score (<3). RESULTS Of the 1272 included caregivers, 543 reported high ACE or low resilience, and 63 reported both. We developed the following regression models: sociodemographic variables in EHR (Model 1), EHR sociodemographics and geomarkers (Model 2), and EHR sociodemographics, geomarkers, and additional survey-reported household characteristics (Model 3). The ability of models to identify the presence of caregiver adversity was poor (all areas under receiver operating characteristics curves were <0.65). CONCLUSIONS Models using EHR data, geomarkers, and household-level characteristics to identify caregiver adversity had limited utility. Directly asking questions to caregivers or integrating risk and strength assessments during pediatric hospitalization may be a better approach to identifying caregiver adversity.
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Affiliation(s)
- Anita N Shah
- Division of Hospital Medicine
- Department of Pediatrics, University of Cincinnati College of Medicine
| | | | - Mohammad An Bhuiyan
- Division of Clinical Informatics, Department of Medicine, Louisiana State University Health Sciences Center
| | | | | | - Jeffrey M Simmons
- Division of Hospital Medicine
- James M. Anderson Center for Health Systems Excellence
- Department of Pediatrics, University of Cincinnati College of Medicine
| | - Samir S Shah
- Division of Hospital Medicine
- James M. Anderson Center for Health Systems Excellence
- Department of Pediatrics, University of Cincinnati College of Medicine
| | - Cole Brokamp
- Division of Biostatistics and Epidemiology
- Department of Pediatrics, University of Cincinnati College of Medicine
| | - Andrew F Beck
- Division of Hospital Medicine
- James M. Anderson Center for Health Systems Excellence
- General and Community Pediatrics
- Department of Pediatrics, University of Cincinnati College of Medicine
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Abstract
Violence and other antisocial behaviors, including fighting and weapon carrying, are highly prevalent among adolescents but usually decrease in young adulthood. Childhood adversities, including exposure to abuse, intimate partner violence, and household substance use and mental health problems, have been linked to violent behaviors in adolescence and adulthood. However, few studies of childhood adversity as determinants of persistent violent behavior among community-based samples have been conducted. Furthermore, the effects of adversity timing and duration on subsequent violent behaviors are unclear. We examined the association between five childhood adversity trajectories (representing stable-low, stable-mild, decreasing, increasing, and stable-high adversity from birth through age 11.5 years) and physical fighting and weapon carrying at ages 13-20 years among a sample of young adults followed continuously since birth from the Avon Longitudinal Study of Parents and Children (n = 9,665). The prevalence of violent behaviors declined sharply as participants aged (e.g., whereas 42.8% reported engaging in physical fighting in the past year at ages 13-15 years, this dropped to 10.4% at ages 17-20 years). Childhood adversity trajectories exhibited a strong dose-response relation with physical fighting and weapon carrying, with particularly pronounced relations for violent behaviors persisting across both adolescence and early adulthood (e.g., for physical fighting at both ages 13-15 years and 17-20 years compared to no fighting at either period, adjusted odds ratio [aOR] = 1.62, 95% confidence interval [CI] = 1.31-2.00 for stable-mild; aOR = 2.33, 95% CI = 1.64-3.33 for decreasing; aOR = 3.18, 95% CI = 2.20-4.60 for increasing; and aOR = 3.73, 95% CI = 2.13-6.52 for stable-high adversity, compared to stable-low adversity). This work highlights the substantial implications of exposure to childhood adversity for youth violence prevention.
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Affiliation(s)
- Madeleine Salo
- University at Albany School of Public Health, State University of New York, USA
| | - Allison A. Appleton
- University at Albany School of Public Health, State University of New York, USA
| | - Melissa Tracy
- University at Albany School of Public Health, State University of New York, USA
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Purtle J, Nelson KL, Gollust SE. Public Opinion About Adverse Childhood Experiences: Social Stigma, Attribution of Blame, and Government Intervention. Child Maltreat 2022; 27:344-355. [PMID: 33769126 DOI: 10.1177/10775595211004783] [Citation(s) in RCA: 7] [Impact Index Per Article: 3.5] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Abstract] [Key Words] [MESH Headings] [Track Full Text] [Subscribe] [Scholar Register] [Indexed: 06/12/2023]
Abstract
Adverse childhood experiences (ACEs) are receiving increasing attention in academic, policy, and media discourses. However, no public opinion research has focused on ACEs. We conducted a nationally representative survey of U.S. adults to address this knowledge gap. A web-based survey was conducted using the Ipsos KnowledgePanel (N = 503, completion rate = 60.5%) in fall 2019. We found that inter-personal stigma and parental blame related to ACEs were prevalent, with 25.0% of respondents unwilling to have a person with "a lot of ACEs" as a close co-worker and 65.2% believing that parents were very much to blame for the consequences of ACEs. Fifty percent of respondents believed that government intervention to prevent ACEs was very important. After adjustment for demographic characteristics, inter-personal stigma toward people with ACEs and conservative ideology were significantly associated with lower perceived importance of government intervention to prevent ACEs. Black race, Hispanic ethnicity, and female gender were significantly associated with higher perceived importance of government intervention. These findings provide an empirical foundation to inform strategies to communicate ACE science to public and policymaker audiences.
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Affiliation(s)
- Jonathan Purtle
- Department of Health Management and Policy, Drexel University Dornsife School of Public Health, Philadelphia, PA, USA
| | - Katherine L Nelson
- Department of Health Management and Policy, Drexel University Dornsife School of Public Health, Philadelphia, PA, USA
| | - Sarah E Gollust
- Division of Health Policy and Management, University of Minnesota School of Public Health, Minneapolis, MN, USA
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Cohen JR, Choi JW. Is ACEs Screening for Adolescent Mental Health Accurate and Fair? Prev Sci 2022; 23:1216-1229. [PMID: 35778650 DOI: 10.1007/s11121-022-01391-3] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Abstract] [Key Words] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Accepted: 06/02/2022] [Indexed: 10/17/2022]
Abstract
Increasingly, adversity-focused assessment tools are being introduced into preventive mental health screening protocols. However, few studies have explicitly examined whether use of these instruments serves as equitable, clinically useful measures of mental health risk in adolescents. In response, the present study examined whether an adverse childhood experiences (ACEs) measure was accurate and fair as an index of environmental risk for adolescent mental health diagnoses. Secondary data analyses were conducted on the National Comorbidity Survey-Adolescent Supplement. Adolescents (N = 10,148; AgeMean = 15.20; 51.3% male; 65.6% White, 15.1% Black, and 14.4% Hispanic) answered ten questions concerning childhood adversities and completed diagnostic interviews for PTSD, depression, and externalizing disorders. In the overall sample, ACEs showed some clinical utility (e.g., area under the curve (AUCs) ≥ 0.64), diagnostic likelihood ratios (DLRs) > 4.0) and acceptable calibration (i.e., expected/observed indices' confidence intervals included 1) across diagnoses. Within subpopulations, however, predictive validity varied. The AUCs were lower for multiple diagnoses in Black male and Hispanic female adolescents and DLRs suggested greater clinical utility for indexing mental health in White, female adolescents. Finally, models were not well-calibrated between adolescent subpopulations, suggesting recommended ACEs screening can potentially produce biased results when used to inform mental health policy and prevention. Reasons for why results from ACEs screening may vary across adolescent subpopulations and the importance of testing statistical fairness for preventive mental health screening are discussed.
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Affiliation(s)
- Joseph R Cohen
- Department of Psychology, University of Illinois at Urbana-Champaign, 603 East Daniel St., IL, 61820, Champaign, USA.
| | - Jae Wan Choi
- Department of Psychology, University of Illinois at Urbana-Champaign, 603 East Daniel St., IL, 61820, Champaign, USA
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Byers T, Newton K, Whitman T, Jones CW. Prevalence of and Relationship Between Caregiver Adversity Scores and Child Client Eco-systemic Structural Family Therapy (ESFT) Outcome: Implications for Family Based Mental Health Services (FBMHS). Community Ment Health J 2022; 58:895-906. [PMID: 34609634 PMCID: PMC8490852 DOI: 10.1007/s10597-021-00897-4] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Abstract] [Key Words] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Submit a Manuscript] [Subscribe] [Scholar Register] [Received: 08/15/2021] [Accepted: 09/21/2021] [Indexed: 11/29/2022]
Abstract
Adverse childhood experiences, especially with primary caregivers, impacts the mental, physical, and relational health of individuals (Felitti et al. in Am J Prev Med, 14(4):245-258. https://doi.org/10.1016/s0749-3797(98)00017-8 , 1998). Therefore, caregiver adversity is important to consider when delivering therapeutic interventions to children (Gardner et al. in Clin Soc Work J 42(1):81-89. https://doi.org/10.1007/s10615-012-0428-8 , 2014; Eslinger et al. in J Child Fam Stud 24(9):2757. https://doi.org/10.1007/s10826-014-0079-1 , 2015; Hagan et al. in J Trauma Stress 30(6):690-697, 2017). This study analyzed archival data to understand the role of caregiver adversity in Eco-Systemic Structural Family Therapy (ESFT) outcomes, within Family Based Mental Health Services. Results indicate caregiver lifetime adversity score did not predict treatment outcome. However, caregiver current adversity and family length of stay were negatively correlated as were length of stay and client discharge level of care. These findings suggest that ESFT benefits families regardless of caregiver childhood adversity level and that clinician attention to caregiver current adversity is important to ensure families receive the full benefits of ESFT. Implications for optimizing ESFT and future directions for ESFT clinical research are discussed.
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Affiliation(s)
- Tara Byers
- Shippensburg University of Pennsylvania, 1871 Old Main Drive, Shippensburg, PA, 17257, USA.
| | - Kathryn Newton
- Shippensburg University of Pennsylvania, 1871 Old Main Drive, Shippensburg, PA, 17257, USA
| | - Todd Whitman
- Shippensburg University of Pennsylvania, 1871 Old Main Drive, Shippensburg, PA, 17257, USA
| | - C Wayne Jones
- Center for Family Based Training, 1 Bala Ave, Suite 125, Bala Cynwyd, PA, 19004, USA
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Purtle J, Nelson KL, Gebrekristos L, Lê-Scherban F, Gollust SE. Partisan differences in the effects of economic evidence and local data on legislator engagement with dissemination materials about behavioral health: a dissemination trial. Implement Sci 2022; 17:38. [PMID: 35729630 PMCID: PMC9213102 DOI: 10.1186/s13012-022-01214-7] [Citation(s) in RCA: 1] [Impact Index Per Article: 0.5] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Abstract] [Key Words] [MESH Headings] [Grants] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Received: 11/01/2021] [Accepted: 06/02/2022] [Indexed: 11/10/2022] Open
Abstract
BACKGROUND State legislators make policy decisions that influence children's exposure to adverse childhood experiences (ACEs), such as child maltreatment, and their effects on behavioral health. Effective dissemination of scientific research can increase the likelihood that legislators' decisions are aligned with evidence to prevent ACEs and their consequences, and effective dissemination requires legislators to engage with dissemination materials. Informed by the elaboration likelihood model of persuasive communication and Brownson's Model of Dissemination Research, we tested the hypothesis that inclusion of economic evidence and local data would increase legislator engagement with dissemination materials about evidence-supported policies related to ACEs and behavioral health. METHODS A three-arm randomized dissemination trial was conducted. A university researcher e-mailed dissemination materials which contained evidence about ACEs and behavioral health problems to state legislators (two e-mails sent 2 weeks apart, 12,662 e-mails delivered to 6509 legislators). The e-mail subject lines, text, and policy brief content were manipulated across the study arms. The intervention condition received state-tailored data about rates of ACEs and state-tailored economic evidence about the costs of ACEs for public systems, the enhanced control condition received state-tailored data and not economic evidence, and the control condition received national data and not economic evidence. Outcomes were rates of e-mail views, policy brief link clicks, requests for researcher consultation, and mentions of child maltreatment terms in legislators' social media posts. RESULTS For the first e-mail, the e-mail view rate was 42.6% higher in the intervention than in the enhanced control condition (22.8% vs. 14.8%) and 20.8% higher than in the control condition (22.8% vs. 18.5%) (both p < .0001). Similar results were observed for the second e-mail. These differences remained significant after adjustment for demographic differences across study conditions in individual-level models, but not multilevel models. There was a significant interaction between the experimental condition and political party (p < .0001) in which the intervention increased e-mail view rates among Democrats but not Republicans. The intervention had no effect on policy brief link clicks or requests for consultation and a mixed effect on social media posts. CONCLUSIONS Inclusion of state-tailored economic evidence in dissemination materials can increase engagement with research evidence among Democrat, but not Republican, legislators. Dissemination strategies tailored for legislators' political party affiliation may be needed.
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Affiliation(s)
- Jonathan Purtle
- New York University School of Global Public Health, New York City, USA.
| | | | | | | | - Sarah E Gollust
- University of Minnesota School of Public Health, Minneapolis, USA
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Alsubaie MA, Alkhalifah HA, Ali AH, Bahabri MA, Alharbi BA, Alfakeh SA. Adverse Childhood Experiences and Their Effect on Irritable Bowel Syndrome Among Saudi Arabian Adults. Cureus 2022; 14:e25791. [PMID: 35812574 PMCID: PMC9270910 DOI: 10.7759/cureus.25791] [Citation(s) in RCA: 1] [Impact Index Per Article: 0.5] [Reference Citation Analysis] [What about the content of this article? (0)] [Abstract] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Accepted: 06/09/2022] [Indexed: 12/04/2022] Open
Abstract
Background Adverse childhood experiences (ACEs) are traumatic events that occur before 18 years of age. ACEs have been associated with many negative health problems, including the development of chronic diseases, such as irritable bowel syndrome (IBS), a functional gastrointestinal disorder characterized by abdominal pain. We investigated the prevalence of ACEs among patients with IBS, identified the types of ACEs commonly related to patients with IBS, and further assessed the impact of ACEs on IBS severity. Methodology A cross-sectional study was performed. The study targeted patients with IBS aged ≥ 18 years who were recruited from gastroenterology outpatient clinics at King Abdulaziz University Hospital. Adults were contacted and invited to take part in the study by completing a survey. Data were collected using two validated questionnaires, the ACE questionnaire for adults and the IBS symptom severity scoring system. Results The study included 109 patients with IBS (59.6% females). The prevalence of ACEs (patients with IBS exposed to at least one ACE) was 63.3%. The most prevalent type was emotional abuse (34.9%), followed by both physical abuse and emotional neglect (28.4%). Females reported significantly more ACEs (p = 0.035) than males. The overall IBS symptoms (r = 0.195, p = 0.043) and abdominal pain (r = 0.240, p = 0.012) severity were significantly correlated with total ACEs score. Conclusions Our findings point to a probable association between ACEs exposure and IBS, demonstrating their long-term impacts on symptoms severity. Further studies are needed to acquire a better understanding of the potential impact of ACEs on IBS.
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Sosnowski DW, Feder KA, Astemborski J, Genberg BL, Letourneau EJ, Musci RJ, Mojtabai R, McCall L, Hollander E, Loving L, Maher BS, Kirk GD, Mehta SH, Sun J. Adverse childhood experiences and comorbidity in a cohort of people who have injected drugs. BMC Public Health 2022; 22:986. [PMID: 35578217 PMCID: PMC9109307 DOI: 10.1186/s12889-022-13369-5] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Abstract] [Key Words] [MESH Headings] [Grants] [Track Full Text] [Download PDF] [Journal Information] [Subscribe] [Scholar Register] [Received: 12/10/2021] [Accepted: 04/20/2022] [Indexed: 11/10/2022] Open
Abstract
BACKGROUND Childhood adversity is associated with the onset of harmful adult substance use and related health problems, but most research on adversity has been conducted in general population samples. This study describes the prevalence of adverse childhood experiences in a cohort of people who have injected drugs and examines the association of these adverse experiences with medical comorbidities in adulthood. METHODS Six hundred fifty three adults were recruited from a 30-year cohort study on the health of people who have injected drugs living in and around Baltimore, Maryland (Median age = 47.5, Interquartile Range = 42.3-52.3 years; 67.3% male, 81.1% Black). Adverse childhood experiences were assessed retrospectively in 2018 via self-report interview. Lifetime medical comorbidities were ascertained via self-report of a provider diagnosis. Multinomial logistic regression with generalized estimating equations was used to examine the association between adversity and comorbid conditions, controlling for potential confounders. RESULTS Two hundred twelve participants (32.9%) reported 0-1 adverse childhood experiences, 215 (33.3%) reported 2-4, 145 (22.5%) reported 5-9, and 72 (11.1%) reported ≥10. Neighborhood violence was the most commonly reported adversity (48.5%). Individuals with ≥10 adverse childhood experiences had higher odds for reporting ≥3 comorbidities (Adjusted Odds Ratio = 2.9, 95% CI = 1.2 - 6.8, p = .01). CONCLUSIONS Among people who have injected drugs, adverse childhood experiences were common and associated with increased occurrence of self-reported medical comorbidities. Findings highlight the persistent importance of adversity for physical health even in a population where all members have used drugs and there is a high burden of comorbidity.
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Affiliation(s)
- David W Sosnowski
- Department of Mental Health, Bloomberg School of Public Health, Johns Hopkins University, Baltimore, MD, USA
| | - Kenneth A Feder
- Department of Mental Health, Bloomberg School of Public Health, Johns Hopkins University, Baltimore, MD, USA
| | - Jacquie Astemborski
- Department of Epidemiology, Bloomberg School of Public Health, Johns Hopkins University, Baltimore, MD, USA
| | - Becky L Genberg
- Department of Epidemiology, Bloomberg School of Public Health, Johns Hopkins University, Baltimore, MD, USA
| | - Elizabeth J Letourneau
- Department of Mental Health, Bloomberg School of Public Health, Johns Hopkins University, Baltimore, MD, USA
| | - Rashelle J Musci
- Department of Mental Health, Bloomberg School of Public Health, Johns Hopkins University, Baltimore, MD, USA
| | - Ramin Mojtabai
- Department of Mental Health, Bloomberg School of Public Health, Johns Hopkins University, Baltimore, MD, USA
- Johns Hopkins University School of Medicine, Baltimore, MD, USA
| | - Lisa McCall
- Department of Epidemiology, Bloomberg School of Public Health, Johns Hopkins University, Baltimore, MD, USA
| | - Eileen Hollander
- Department of Epidemiology, Bloomberg School of Public Health, Johns Hopkins University, Baltimore, MD, USA
| | - Lynnet Loving
- Department of Epidemiology, Bloomberg School of Public Health, Johns Hopkins University, Baltimore, MD, USA
| | - Brion S Maher
- Department of Mental Health, Bloomberg School of Public Health, Johns Hopkins University, Baltimore, MD, USA
| | - Gregory D Kirk
- Department of Epidemiology, Bloomberg School of Public Health, Johns Hopkins University, Baltimore, MD, USA
- Johns Hopkins University School of Medicine, Baltimore, MD, USA
| | - Shruti H Mehta
- Department of Epidemiology, Bloomberg School of Public Health, Johns Hopkins University, Baltimore, MD, USA
- Johns Hopkins University School of Medicine, Baltimore, MD, USA
| | - Jing Sun
- Department of Epidemiology, Bloomberg School of Public Health, Johns Hopkins University, Baltimore, MD, USA.
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DePuy AM, Patterson ML, Rodriguez NP, Patel‐Shori NM, Yu D, Jacob R. Evaluating the Impact of Adverse Childhood Experiences on Medication Use. J Am Coll Clin Pharm 2022. [DOI: 10.1002/jac5.1650] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 11/06/2022]
Affiliation(s)
- Ashley M. DePuy
- Department of Pharmacy Practice Temple University School of Pharmacy Philadelphia PA
| | - Michelle L. Patterson
- Department of Pharmacy Practice Temple University School of Pharmacy Philadelphia PA
| | - Natalie P. Rodriguez
- Department of Pharmacy Practice Temple University School of Pharmacy Philadelphia PA
| | - Nima M. Patel‐Shori
- Department of Pharmacy Practice Temple University School of Pharmacy Philadelphia PA
| | - Daohai Yu
- Department of Biomedical Education and Data Science Lewis Katz School of Medicine at Temple University Philadelphia PA
| | - Regina Jacob
- MSCE Section of General Internal Medicine Lewis Katz School of Medicine at Temple University Philadelphia PA
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Mandviwala TM, Hall J, Beale Spencer M. The Invisibility of Power: A Cultural Ecology of Development in the Contemporary United States. Annu Rev Clin Psychol 2022; 18:179-199. [PMID: 35061521 DOI: 10.1146/annurev-clinpsy-072220-015724] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Abstract] [Key Words] [MESH Headings] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 08/19/2023]
Abstract
This article highlights the invisible power those in racial and gendered privilege continue to hold in the contemporary United States and the harmful psychological effects of this power on both those it oppresses and, importantly, those who wield it. A lack of empathy and an inability for compassion arise in individuals holding sociopolitical and cultural power, and we highlight how this psychological condition is qualifiable as psychosis and question why it has not been discussed as such in the literature until now. We also, however, bring attention to the invisible psychological power that marginalized populations in the United States hold, invisible because it has been left largely unrecognized by mainstream cultural forces. By centering the ways American cultural minorities successfully navigate multiply oppressive structural systems, we conclude with a reflection on how intersectional feminism can offer a philosophical lens through which to mitigate the unhealthy developmental outcomes and effects of White heteronormative male power.
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Affiliation(s)
- Tasneem M Mandviwala
- Department of Comparative Human Development, University of Chicago, Chicago, Illinois, USA;
| | - Jennifer Hall
- Social Intervention Group, School of Social Work, Columbia University, New York, NY, USA
| | - Margaret Beale Spencer
- Department of Comparative Human Development, University of Chicago, Chicago, Illinois, USA;
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Keane K, Evans RR. The Potential for Teacher-Student Relationships and the Whole School, Whole Community, Whole Child Model to Mitigate Adverse Childhood Experiences. J Sch Health 2022; 92:504-513. [PMID: 35191030 DOI: 10.1111/josh.13154] [Citation(s) in RCA: 1] [Impact Index Per Article: 0.5] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Abstract] [Key Words] [MESH Headings] [Track Full Text] [Subscribe] [Scholar Register] [Received: 04/28/2021] [Revised: 10/12/2021] [Accepted: 11/04/2021] [Indexed: 06/14/2023]
Abstract
BACKGROUND Adverse childhood experiences (ACEs) are associated with poorer health and educational outcomes. With over 20% of children experiencing multiple ACEs, interventions must target protective factors to improve outcomes among these students. Teacher-student relationships (TSRs) integrated with the Whole School, Whole Community, Whole Child (WSCC) are one promising approach to building resilience to overcome ACEs. METHODS A narrative literature review was conducted on ACEs, resilience, TSRs, and the WSCC model to explore the evidence and potential of TSR interventions integrated within the WSCC model to build resilience in students experiencing ACEs. RESULTS Supportive adult relationships are one of the strongest protective factors against ACEs. TSR interventions have improved student and relationship outcomes. Few studies have explored the relationship between TSRs and ACEs or TSR ACEs interventions. The WSCC model provides opportunities to integrate TSRs and other protective factors into a schoolwide health model to build resilience. CONCLUSIONS TSRs and the WSCC model are promising approaches to target protective factors to mitigate ACEs. Research is needed to further establish TSRs as a protective factor, explore TSR ACEs interventions, and determine best practices for integrating TSRs and resilience in the WSCC model.
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Affiliation(s)
- Kevin Keane
- University of Alabama at Birmingham, 1720 2nd Avenue South, NB 203C, Birmingham, AL, 35294-1210
| | - Retta R Evans
- University of Alabama at Birmingham, 1150 10th Avenue South, EEC 304B, Birmingham, AL, 35294-1250
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Suglia SF, Saelee R, Guzman I, Elsenburg LK, Clark CJ, Link B, Koenen KC. Child socioeconomic status, Childhood adversity and adult socioeconomic status in a nationally representative sample of young adults. SSM Popul Health 2022. [PMID: 35601218 PMCID: PMC9118918 DOI: 10.1016/j.ssmph.2022.101094] [Citation(s) in RCA: 10] [Impact Index Per Article: 5.0] [Reference Citation Analysis] [What about the content of this article? (0)] [Abstract] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Received: 02/08/2022] [Revised: 03/25/2022] [Accepted: 04/05/2022] [Indexed: 11/24/2022] Open
Abstract
Introduction Methods Results Conclusions In a nationally representative sample of US adolescents lower childhood socioeconomic status is associated with childhood adversity. Additionally, childhood adversities were associated with lower adult socioeconomic status. In mediation analyses, childhood adversity partially mediated the relation between childhood socioeconomic status and adult socioeconomic status.
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Martin KJ, Castano C, Geraghty S, Horner SR, McCann E, Beck AF, Xu Y, Gomez L, O'Dea C, Jacquez F, Clark VLP, Rule ARL. Barriers and Facilitators to Prevention and Care of COVID-19 Infection in Cincinnati Latinx Families: a Community-Based Convergent Mixed Methods Study. J Racial Ethn Health Disparities 2022. [PMID: 35411496 DOI: 10.1007/s40615-022-01294-7] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [What about the content of this article? (0)] [Abstract] [Key Words] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Received: 01/14/2022] [Revised: 03/08/2022] [Accepted: 03/25/2022] [Indexed: 11/25/2022]
Abstract
Background Latinx populations have experienced disproportionately high case rates of COVID-19 across the USA. Latinx communities in non-traditional migration areas may experience greater baseline day-to-day challenges such as a lack of resources for immigrants and insufficient language services. These challenges may be exacerbated by the COVID-19 pandemic. Objective This article describes the results of an initial community health needs assessment to better understand the prevention and care of COVID-19 infection in the Cincinnati Latinx community. Methods We used convergent mixed methods to examine barriers and facilitators to COVID-19 prevention and care for those with infection. Results Latinx adults ≥ 18 years old completed 255 quantitative surveys and 17 qualitative interviews. Overarching mixed methods domains included knowledge, prevention, work, challenges, and treatment. Quantitative results largely reinforced qualitative results (confirmation). Certain quantitative and qualitative results, however, diverged and expanded insights related to caring for COVID-19 infection among Latinx adults (expansion). There were infrequent contradictions between quantitative and qualitative findings (discordance). Primary barriers for the Latinx community during the COVID-19 pandemic included insecurities in food, jobs, housing, and immigration. Key facilitators included having trusted messengers of health-related information. Conclusion Public health interventions should be centered on community partnerships and the use of trusted messengers. Wraparound services (including resources for immigrants) are essential public health services. Close partnership with employers is essential as lack of sick leave and mask supplies were more frequent barriers than knowledge. These findings emerged from experiences during the COVID-19 pandemic but likely generalize to future public health crises. Supplementary Information The online version contains supplementary material available at 10.1007/s40615-022-01294-7.
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Bernard DL, Smith Q, Lanier P. Racial discrimination and other adverse childhood experiences as risk factors for internalizing mental health concerns among Black youth. J Trauma Stress 2022; 35:473-483. [PMID: 34800051 PMCID: PMC9035019 DOI: 10.1002/jts.22760] [Citation(s) in RCA: 7] [Impact Index Per Article: 3.5] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Abstract] [Track Full Text] [Journal Information] [Submit a Manuscript] [Subscribe] [Scholar Register] [Received: 03/18/2021] [Revised: 08/23/2021] [Accepted: 08/27/2021] [Indexed: 11/06/2022]
Abstract
Adverse childhood experiences (ACEs) have been consistently linked to a reduction in healthy psychological adjustment among youth. Emergent evidence suggests that there are culturally specific ACEs, such as racial discrimination, that are particularly harmful to the mental health of Black youth. However, the psychological impact of racial discrimination on the mental health of Black youth relative to other ACEs remains underexplored. The present study aimed to address this gap by examining the extent to which racial discrimination was associated with other ACEs and elucidating the unique associations between children's experiences of racial discrimination and internalizing problems (i.e., depression, anxiety), after controlling for other ACEs. Data consisted of a subsample of Black children from the National Survey of Children's Health (N = 8,672; Mage = 9.8 years; 51.1% male). Bivariate analyses illustrated that racial discrimination was positively associated with the co-occurrence of all other ACEs measured within the current study. Multivariable analyses using generalized linear mixed models revealed that racial discrimination was significantly associated with youth diagnoses of depression, adjusted odds ratio (aOR) = 1.35, 95% CI [1.23, 1.49], and anxiety, aOR = 1.39, 95% CI [1.31, 1.47], after controlling for other ACEs and sociodemographic covariates. The findings demonstrate that racial discrimination is comparably associated with youth internalizing problems relative to ACEs conventionally examined within the childhood trauma literature. The importance of these results, including how this knowledge can be leveraged to inform clinical practice and policy to promote the positive mental health of Black youth, are also discussed.
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Affiliation(s)
- Donte L. Bernard
- National Crime Victims Research and Treatment Center, Department of Psychiatry and Behavioral Sciences, Medical University of South Carolina, Charleston, South Carolina, USA
| | - Quinton Smith
- School of Social Work, University of North Carolina at Chapel Hill, Chapel Hill, North Carolina, USA
| | - Paul Lanier
- School of Social Work, University of North Carolina at Chapel Hill, Chapel Hill, North Carolina, USA
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Helton JJ, Davis JP, Lee DS, Pakdaman S. Expanding adverse child experiences to inequality and racial discrimination. Prev Med 2022; 157:107016. [PMID: 35301044 DOI: 10.1016/j.ypmed.2022.107016] [Citation(s) in RCA: 1] [Impact Index Per Article: 0.5] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Abstract] [Key Words] [Track Full Text] [Journal Information] [Submit a Manuscript] [Subscribe] [Scholar Register] [Received: 09/23/2021] [Revised: 12/30/2021] [Accepted: 02/28/2022] [Indexed: 11/26/2022]
Abstract
There is a well-established correlation between health and adverse childhood experiences (ACEs). Arguments have been made to expand ACE scales to include indicators of racism and structural inequalities. In this paper, we use nationally representative data to examine the relationships between latent groups of an expanded adversity scale and a broad range of child health outcomes. Data were obtained from a merger of the 2017 and 2018 National Survey of Children's Health (NSCH) and analyzed in 2021 (n = 52,129). Adversities were defined as violent victimization, violence exposure, a range of parental problems, racial discrimination, food insecurity, and unkempt housing. Latent class analysis (LCA) was used to uncover emergent groups of adversities, and logistic regression was used to assess group relationship to global and diagnosed measures of health. Four groups emerged: high all (3.6%), material and food hardship (11.9%), parental problems (10.3%), and low all (74.2%). Results showed the high all groups at greater odds of almost all outcomes. Compared to low all group, high all had particularly higher odds of any special (OR = 2.29) or complex (OR = 2.53) healthcare need, frequent severe headaches (OR = 2.07), and depression (OR = 3.4) or anxiety (OR = 2.11). Our analysis noted separation of experiences based on additional items related to structural inequalities: food insecurity, poverty, and unkempt housing. However, augmenting existing ACE scales with these indicators may be unnecessary as children most at-risk for poor health were a very small group (1 in 28) that experienced multiple forms of violence and parental problems.
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Affiliation(s)
- Jesse J Helton
- College of Public Health and Social Justice, School of Social Work, St. Louis University, St. Louis, MO, United States of America.
| | - Jordan P Davis
- USC Center for Artificial Intelligence in Society, United States of America; USC Center for Mindfulness Science, United States of America; USC Institute for Addiction Science, United States of America; Suzanne Dworak-Peck School of Social Work, University of Southern California, Los Angeles, CA, United States of America
| | - Daniel S Lee
- Suzanne Dworak-Peck School of Social Work, University of Southern California, Los Angeles, CA, United States of America
| | - Sheila Pakdaman
- Suzanne Dworak-Peck School of Social Work, University of Southern California, Los Angeles, CA, United States of America
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Amone-P'Olak K. Prevalence, distribution and attributable risks of adverse childhood experiences in different family types: A survey of young adults in Botswana. Child Abuse Negl 2022; 126:105513. [PMID: 35144077 DOI: 10.1016/j.chiabu.2022.105513] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Abstract] [Key Words] [MESH Headings] [Track Full Text] [Subscribe] [Scholar Register] [Received: 04/10/2021] [Revised: 11/15/2021] [Accepted: 01/14/2022] [Indexed: 06/14/2023]
Abstract
BACKGROUND Although adverse childhood experiences (ACEs) are often associated with poor outcomes in adulthood, little is known about its distribution in various family types, especially in low- and middle-income countries. OBJECTIVE We assessed the prevalence, distribution, and attributable risks of ACEs in different family types in early adults. METHODS Using data from 483 young adults (18-25 years of age), we assessed the prevalence and distribution of ACEs and employed binary logistic regressions to quantify the attributable risk of ACEs in different family types: nuclear (reference), single-mother, separated/divorced, and extended family types. We compared respondents without reports of ACEs (reference) to those reporting different numbers of ACEs (1 or more, 2 or more, 3 or more, 4 or more and 5 or more) to assess attributable risks of ACEs in different family types. RESULTS Out of the 483 participants, (female = 262 [53.3%]), 26.7% reported no ACEs, 21.1% reported 1 ACE, 13.3% reported 2 ACEs, and 38.9% reported 3 or more ACEs. Two hundred thirty-two (48%) and 153 (31.7%) students reported that they were from a nuclear and single-mother family types, respectively. Overall, there were higher densities of ACEs in single-mother and separated/divorced compared to nuclear family type. Compared to nuclear family type, the attributable risks of ACEs for single-mother family type ranged from 2.85 (95% Confidence Intervals (CI) 1.65) to 4.13 (95% CI: 1.92-8.91) and for separate/divorced family type ranging from 3.69 (95% CI: 1.72) to 6.32 (95% CI: 2.40-16.64). CONCLUSIONS The odds of ACEs differ with family types and were markedly pronounced in single-mother and separated/divorced compared to nuclear family types. Interventions to mitigate the effects of ACEs should be targeted at family types with a high density of ACEs. Professionals should design programmes targeting single-mother, separated/divorced and extended family types to alleviate the negative effects of childhood adversity.
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Affiliation(s)
- Kennedy Amone-P'Olak
- Department of Psychology, Faculty of Social Sciences, Kyambogo University, Uganda.
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Wojciak AS, Powers J, Chan ACY, Pleggenkuhle AL, Hooper LM. ARCCH Model of Resilience: A Flexible Multisystemic Resilience Framework. Int J Environ Res Public Health 2022; 19:3920. [PMID: 35409602 DOI: 10.3390/ijerph19073920] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [What about the content of this article? (0)] [Abstract] [Key Words] [Track Full Text] [Download PDF] [Figures] [Subscribe] [Scholar Register] [Received: 02/08/2022] [Revised: 03/14/2022] [Accepted: 03/22/2022] [Indexed: 02/05/2023]
Abstract
The increasing prevalence and impact of trauma, such as adverse childhood experiences, race-based trauma, and a global pandemic, highlight the critical need for a flexible multisystemic framework of resilience. This manuscript outlines the universality of trauma and resilience and also provides a description of the gaps in existing resilience frameworks that led to the development of a flexible multisystemic resilience framework entitled the ARCCH Model of Resilience. Attachment, Regulation, Competence, Culture, and Health are elements of personal and cultural identities, families, communities, and systems that can be used to evaluate strengths, identify areas that need support, and provide steps for culturally responsive and ecologically valid interventions. A multisystemic application of ARCCH is provided.
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Zhang X, Monnat SM. Racial/ethnic differences in clusters of adverse childhood experiences and associations with adolescent mental health. SSM Popul Health 2022; 17:100997. [PMID: 34984220 PMCID: PMC8693281 DOI: 10.1016/j.ssmph.2021.100997] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Abstract] [Key Words] [Grants] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Received: 04/13/2021] [Revised: 12/05/2021] [Accepted: 12/06/2021] [Indexed: 11/19/2022] Open
Abstract
Childhood adversity is a well-established risk factor for mental health problems during adolescence. Using data from the Fragile Families and Child Wellbeing Study and latent class analysis (LCA), we examined patterns of exposure to ten adverse childhood experiences (ACEs), including socioeconomic adversity, among non-Hispanic (NH) White, NH Black, and Hispanic 9 year olds and determined associations between membership in ACE exposure “classes” and depression and anxiety scores at age 15 (N = 2849). Parental separation/divorce, economic hardship, and paternal incarceration were the most common ACEs. ACE prevalence was significantly higher among Blacks and Hispanics. ACEs clustered into four classes for Whites and Hispanics and three classes for Blacks. Over half of Whites were classified in the ‘Low Adversity’ class. Conversely, most Black and Hispanic adolescents were classified in the ‘High Socioeconomic Adversity and Paternal Incarceration’ class, characterized by above average probabilities of experiencing family economic hardship, parental separation/divorce, low maternal education, and paternal incarceration. A small share of adolescents in all three racial/ethnic groups were in the ‘High Global Adversity’ class, characterized by high probability of exposure to most ACEs, including physical and psychological abuse. Finally, ACE class membership was differentially associated with anxiety and depression across the three racial/ethnic groups, with generally larger differences in mental health scores across ACE groups for Whites than for Blacks and Hispanics. Our findings suggest that studies on the associations between ACEs and health outcomes that do not include childhood economic adversity risk underestimating the role of ACEs on mental health among racial/ethnic minorities. Moreover, different patterns of ACE exposure are differentially linked to anxiety and depression, and ACE group membership differences in anxiety and depression vary by racial/ethnic group. Findings suggest the need for racially tailored prevention and intervention strategies. In a U.S. sample of low-income children, 93% experienced at least one ACE in past year. ACEs cluster differently for White, Black, and Hispanic adolescents. Most White adolescents are in a low adversity class. Most Black and Hispanic adolescents are in a high SES adversity and parental incarceration class. There are race differences in relationships between ACE classes and mental health.
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Affiliation(s)
- Xiaoyan Zhang
- Lerner Center for Public Health Promotion, Maxwell School of Citizenship and Public Affairs, Department of Human Development and Family Science, Falk College of Sport and Human Dynamics, Syracuse University, 426 Eggers Hall, Syracuse, NY, 13244, USA
| | - Shannon M. Monnat
- Lerner Center for Public Health Promotion Department of Sociology Maxwell School of Citizenship and Public Affairs, Syracuse University, 426 Eggers Hall, Syracuse, NY, 13244, USA
- Corresponding author.
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Pierce H, Jones MS, Gibbs BG. Early adverse childhood experiences and exclusionary discipline in high school. Soc Sci Res 2022; 101:102621. [PMID: 34823667 DOI: 10.1016/j.ssresearch.2021.102621] [Citation(s) in RCA: 3] [Impact Index Per Article: 1.5] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Abstract] [Key Words] [MESH Headings] [Track Full Text] [Subscribe] [Scholar Register] [Received: 10/08/2020] [Revised: 07/13/2021] [Accepted: 07/23/2021] [Indexed: 06/13/2023]
Abstract
The use of school suspension and expulsion is a widespread phenomenon in American schools (Wallace et al., 2009; Owens and McLanahan, 2020). Yet, much of what we know about these exclusionary practices provide little insight into the personal biographies of the students themselves-specifically their histories of childhood trauma. Using measures of adverse childhood experiences (ACEs), we examine the link between early ACEs (up to age 5) and school suspension/expulsion using the Fragile Families and Child Wellbeing Study (1998-2010) (FFCWS). We find that a child with a cumulative ACE score are almost four times more likely to have been suspended or expelled. Importantly, this negative link persists even when accounting for factors known to be associated with ACEs and school discipline. This work offers new theoretical insight into how we understand discipline in school contexts and suggests the importance of trauma-informed interventions in the American education system.
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Lowry E, McInerney A, Schmitz N, Deschênes SS. Adverse childhood experiences and cognitive function in adulthood: examining the roles of depressive symptoms and inflammation in a prospective cohort study. Soc Psychiatry Psychiatr Epidemiol 2022; 57:2367-77. [PMID: 35753000 DOI: 10.1007/s00127-022-02315-w] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [What about the content of this article? (0)] [Abstract] [Key Words] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Submit a Manuscript] [Subscribe] [Scholar Register] [Received: 09/30/2021] [Accepted: 05/18/2022] [Indexed: 11/17/2022]
Abstract
PURPOSE Adverse childhood experiences (ACEs) have been associated with cognitive decline in adulthood. However, the underlying mechanisms implicated remain unclear. This study investigated depressive symptoms and systemic inflammation as potential mediators of the association between ACEs and later cognitive function. METHODS Participants were adults aged 50 + from the English Longitudinal Study of Ageing (N = 3029; 54.8% female). Measures included self-reported ACEs at wave 3 (2006-2007), C-reactive protein (CRP) and depressive symptoms at wave 4 (2008-2009), and cognitive function at waves 3 and 7 (2014-2015). Mediation analyses examined the direct associations between ACEs and cognitive function at wave 7 and the indirect associations via depressive symptoms and CRP at wave 4. In a first set of analyses, models were adjusted for sociodemographic factors and baseline cognitive function. In a second set of analyses, models were additionally adjusted for BMI and health behaviours (n = 1915). RESULTS Cumulative ACEs exposure positively predicted depressive symptoms (b = 0.184, s.e. = 0.034, p < .001), which in turn predicted poorer cognitive function at wave 7 (b = - 0.035, s.e. = 0.008, p < .001). ACEs also positively predicted systemic inflammation as measured by CRP (b = 0.031, s.e. = 0.01, p = 0.0016). However, CRP did not mediate the association between ACEs and later cognitive function (b = - 0.0002, 95% CI: - 0.002, 0.002). CONCLUSION These findings suggest that ACEs may be related to cognitive decline partly via depressive symptoms and corroborate prior research linking ACEs with systemic inflammation in adulthood.
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Elma JHL, Hautalab D, Abrahamson-Richardsa T, Wallsb ML. Patterns of adverse childhood experiences and mental health outcomes among American Indians with type 2 diabetes. Child Abuse Negl 2021; 122:105326. [PMID: 34627041 PMCID: PMC8784163 DOI: 10.1016/j.chiabu.2021.105326] [Citation(s) in RCA: 2] [Impact Index Per Article: 0.7] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Abstract] [Key Words] [MESH Headings] [Grants] [Track Full Text] [Subscribe] [Scholar Register] [Received: 02/16/2021] [Revised: 08/29/2021] [Accepted: 09/03/2021] [Indexed: 05/02/2023]
Abstract
BACKGROUND Extensive research demonstrates that Adverse Childhood Experiences (ACEs) are highly interconnected and have numerous health consequences well into adulthood. Yet, there is a dearth of focused research that examines ACEs and health inequities for American Indians (AIs). OBJECTIVE To assesses the prevalence of ten types of childhood adversities, explore constellations of exposures, and examine whether there are differential risks of mental health outcomes according to sub-group classification. PARTICIPANTS AND SETTING Adult AIs with type 2 diabetes from five reservation-based tribal communities in the Great Lakes region of the U.S. METHODS Prevalence was estimated using a modified version of the World Health Organization's ACE-International Questionnaire. To examine heterogeneity in ACEs exposures, latent class analysis was used. Risk of mental health outcomes was calculated by class. RESULTS The four most common ACEs reported were residing with someone who abused substances, witnessing household violence, incarceration of a household member, and sexual abuse. Three latent classes were identified: low risk (56.7%), family maladjustment with high probabilities of household violence, incarceration, and substance abuse (27.1%), and complex trauma (16.3%) with moderate to high probabilities of exposure to all ACEs. The most consistent differences in mental health outcomes were between the low risk and complex trauma classes. CONCLUSIONS Identification of a high number of participants in the low-risk class helps structure a more wholistic image of AI families, as negative stereotypes of AIs are abundant. For the minority of individuals in the complex trauma class, risk for chronic mental health challenges and co-morbidities appears to be high.
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Affiliation(s)
- Jessica H L Elma
- University of Washington, United States of America; Johns Hopkins University, United States of America.
| | - Dane Hautalab
- University of Washington, United States of America; Johns Hopkins University, United States of America
| | | | - Melissa L Wallsb
- University of Washington, United States of America; Johns Hopkins University, United States of America
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James C, Jimenez ME, Wade R, Nepomnyaschy L. Adverse Childhood Experiences and Teen Behavior Outcomes: The Role of Disability. Acad Pediatr 2021; 21:1395-1403. [PMID: 34020101 DOI: 10.1016/j.acap.2021.05.006] [Citation(s) in RCA: 3] [Impact Index Per Article: 1.0] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Abstract] [Key Words] [Track Full Text] [Journal Information] [Submit a Manuscript] [Subscribe] [Scholar Register] [Received: 10/28/2020] [Revised: 05/05/2021] [Accepted: 05/12/2021] [Indexed: 11/26/2022]
Abstract
OBJECTIVE To examine associations between adverse childhood experiences (ACEs) and teen behavior outcomes and whether the presence of disability moderates this relationship. METHODS We conducted a secondary analysis of population-based data from the Fragile Families & Child Wellbeing Study urban birth cohort. Disability status included physical/developmental/behavioral conditions (ages 1-5) using mother-reported child health conditions and cognitive disability (age 9), measured by the Peabody Picture Vocabulary Test (PPVT), an assessment of receptive vocabulary. We investigated whether either disability type moderates the relationship between ACEs occurring between ages 5 to 9 and behavior outcomes at age 15, specifically, standardized scales of caregiver-reported externalizing and youth-reported internalizing and delinquent behaviors. Associations were examined using multivariate linear regression models, including interaction effects of ACEs with low PPVT score and disability conditions to assess for potential moderation. RESULTS Of the 3038 children included, 15% had a cognitive disability and 24% had a disabling health condition. The presence of 2 or more ACEs (compared to none) is associated with more externalizing (by 0.34 standard deviations [SD]), internalizing (0.18 SD), and delinquent (0.18 SD) behaviors. Cognitive disability exacerbates this association for externalizing behaviors and delinquent behaviors while other disabling health conditions do not. CONCLUSIONS ACEs were associated with more behavior problems among urban youth. Cognitive disability, but not other disabling health conditions, compounded this association for externalizing and delinquent behaviors, indicating these children may be particularly vulnerable to the effects of trauma and adversity. Targeted assessment and resources for youth with cognitive disability are critical.
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Affiliation(s)
- Christine James
- Rutgers University School of Social Work (C James and L Nepomnyaschy), New Brunswick, NJ.
| | - Manuel E Jimenez
- Departments of Pediatrics and Family Medicine and Community Health, Rutgers Robert Wood Johnson Medical School (ME Jimenez), New Brunswick, NJ; The Boggs Center on Developmental Disabilities (ME Jimenez), New Brunswick, NJ; Child Health Institute of New Jersey (ME Jimenez), New Brunswick, NJ; Children's Specialized Hospital (ME Jimenez), New Brunswick, NJ
| | - Roy Wade
- Division of General Pediatrics, Children's Hospital of Philadelphia (R Wade Jr), Philadelphia, PA; Department of Pediatrics, Perelman School of Medicine at the University of Pennsylvania (R Wade Jr), Philadelphia, PA
| | - Lenna Nepomnyaschy
- Rutgers University School of Social Work (C James and L Nepomnyaschy), New Brunswick, NJ
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Leiva L, Antivilo-bruna A, Torres-cortés B, Peña F, Scquicciarini AM. Relationship between adverse childhood experiences and mental health: Implications for a nationwide school mental health program. Curr Psychol. [DOI: 10.1007/s12144-021-02342-x] [Citation(s) in RCA: 1] [Impact Index Per Article: 0.3] [Reference Citation Analysis] [What about the content of this article? (0)] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 12/16/2022]
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Kornfield SL, White LK, Waller R, Njoroge W, Barzilay R, Chaiyachati BH, Himes MM, Rodriguez Y, Riis V, Simonette K, Elovitz MA, Gur RE. Risk And Resilience Factors Influencing Postpartum Depression And Mother-Infant Bonding During COVID-19. Health Aff (Millwood) 2021; 40:1566-1574. [PMID: 34606353 DOI: 10.1377/hlthaff.2021.00803] [Citation(s) in RCA: 23] [Impact Index Per Article: 7.7] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Abstract] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 11/05/2022]
Abstract
Acute stress during pregnancy can have adverse effects on maternal health and increase the risk for postpartum depression and impaired mother-infant bonding. The COVID-19 pandemic represents an acute environmental stressor during which it is possible to explore risk and resilience factors that contribute to postpartum outcomes. To investigate prenatal risk and resilience factors as predictors of postpartum depression and impaired mother-infant bonding, this study recruited a diverse cohort of 833 pregnant women from an urban medical center in Philadelphia, Pennsylvania, and assessed them once during pregnancy in the early phase of the COVID-19 pandemic (April-July 2020) and again at approximately twelve weeks postpartum. Adverse childhood experiences, prenatal depression and anxiety, and COVID-19-related distress predicted a greater likelihood of postpartum depression. Prenatal depression was the only unique predictor of impaired maternal-infant bonding after postpartum depression was controlled for. Women reporting greater emotion regulation, self-reliance, and nonhostile relationships had healthier postpartum outcomes. Policies to increase the number of nonspecialty providers providing perinatal mental health services as well as reimbursement for integrated care and access to mental health screening and care are needed to improve lifelong outcomes for women and their children.
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Affiliation(s)
- Sara L Kornfield
- Sara L. Kornfield is an assistant professor in the Penn Center for Women's Behavioral Wellness, Department of Psychiatry, Perelman School of Medicine, University of Pennsylvania, in Philadelphia, Pennsylvania. Kornfield and Lauren K. White are co-first authors
| | - Lauren K White
- Lauren K. White is a research scientist in the Lifespan Brain Institute, Children's Hospital of Philadelphia and Department of Psychiatry, Perelman School of Medicine, University of Pennsylvania. White and Sara L. Kornfield are co-first authors
| | - Rebecca Waller
- Rebecca Waller is an assistant professor in the Department of Psychology, University of Pennsylvania
| | - Wanjiku Njoroge
- Wanjiku Njoroge is an assistant professor in the Department of Psychiatry, Perelman School of Medicine, University of Pennsylvania
| | - Ran Barzilay
- Ran Barzilay is an assistant professor in the Lifespan Brain Institute, Children's Hospital of Philadelphia and Department of Psychiatry, Perelman School of Medicine, University of Pennsylvania
| | - Barbara H Chaiyachati
- Barbara H. Chaiyachati is an associate fellow in the Lifespan Brain Institute, Children's Hospital of Philadelphia and Department of Psychiatry, Perelman School of Medicine, University of Pennsylvania
| | - Megan M Himes
- Megan M. Himes is a research assistant in the Lifespan Brain Institute, Children's Hospital of Philadelphia and Department of Psychiatry, Perelman School of Medicine, University of Pennsylvania
| | - Yuheiry Rodriguez
- Yuheiry Rodriguez is a study coordinator in the Department of Psychology, University of Pennsylvania
| | - Valerie Riis
- Valerie Riis is the director of operations, Maternal and Child Health Research Center, Department of Obstetrics and Gynecology, Perelman School of Medicine, University of Pennsylvania
| | - Keri Simonette
- Keri Simonette is a clinical research coordinator at Jefferson Health, in Philadelphia, Pennsylania. She was a project manager with the Maternal Child Health Research Center, Department of Obstetrics and Gynecology, Perelman School of Medicine, University of Pennsylvania, when this work was performed
| | - Michal A Elovitz
- Michal A. Elovitz is a professor in the Department of Obstetrics and Gynecology, Perelman School of Medicine, University of Pennsylvania
| | - Raquel E Gur
- Raquel E. Gur is a professor in the Lifespan Brain Institute, Children's Hospital of Philadelphia and Department of Psychiatry, Perelman School of Medicine, University of Pennsylvania
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Dobbins DL, Berenson LM, Chen H, Quandt SA, Laurienti PJ, Arcury TA. Adverse Childhood Experiences Among Low-Income, Latinx Children in Immigrant Families: Comparison of Children in Rural Farmworker and Urban Non-Farmworker Communities. J Immigr Minor Health 2021. [PMID: 34580801 DOI: 10.1007/s10903-021-01274-9] [Citation(s) in RCA: 1] [Impact Index Per Article: 0.3] [Reference Citation Analysis] [What about the content of this article? (0)] [Abstract] [Key Words] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Accepted: 09/09/2021] [Indexed: 10/20/2022]
Abstract
Adverse childhood experiences (ACEs) are stressors that can have lifelong detrimental health effects. ACEs are a concern for children of immigrant parents. The low-income mothers of 75 rural farmworker and 63 urban non-farmworker 8-year old Latinx children in immigrant families completed a standardized ACEs inventory. 47.1% of mothers reported no ACEs, 33.3% reported 1, 8.7% reported 2, and 10.9% reported 3 or more. A logistic regression model indicated that urban versus rural children had a higher odds (OR = 2.35, 95% CI = 1.01, 5.48) of at least one ACE. Children living in families with 2 versus 1 adults (OR = 0.10, 95% CI = 0.02, 0.49) and 3 versus 1 adults (OR = 0.12, 95% CI = 0.02, 0.78) had a lower odds of at least one ACE. ACEs prevalence was similar to other children in immigrant families, with children living in urban communities having twice the likelihood of experiencing an ACE. Detailed research is needed on locality-based ACEs prevalence.
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Abstract
Most children will experience some type of trauma during childhood, and many children suffer from significant adversities. Research in genetics, neuroscience, and epidemiology all provide evidence that these experiences have effects at the molecular, cellular, and organ level, with consequences on physical, emotional, developmental, and behavioral health across the life span. Trauma-informed care translates that science to inform and improve pediatric care and outcomes. To practically address trauma and promote resilience, pediatric clinicians need tools to assess childhood trauma and adversity experiences as well as practical guidance, resources, and interventions. In this clinical report, we summarize current, practical advice for rendering trauma-informed care across varied medical settings.
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Affiliation(s)
- Heather Forkey
- Department of Pediatrics, University of Massachusetts, Worcester, Massachusetts
| | - Moira Szilagyi
- Divisions of General and Developmental-Behavioral Pediatrics, Department of Pediatrics, University of California, Los Angeles, Los Angeles, California
| | - Erin T Kelly
- Ambulatory Health Services, Philadelphia Department of Public Health, Philadelphia, Pennsylvania
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Lewis QJ, Smith BD, Offiong A, Prioleau M, Powell TW. When a house is never a home: Housing instability among youth affected by parental drug abuse. Child Abuse Negl 2021; 118:105131. [PMID: 34118586 PMCID: PMC8341207 DOI: 10.1016/j.chiabu.2021.105131] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Abstract] [Key Words] [MESH Headings] [Grants] [Track Full Text] [Subscribe] [Scholar Register] [Received: 11/23/2020] [Revised: 05/07/2021] [Accepted: 05/14/2021] [Indexed: 06/12/2023]
Abstract
BACKGROUND The negative consequences of parental substance abuse are significant and longstanding for children. Among other risks, these youth are more likely to experience housing instability. The most common predictor of a child not living with their biological parent is parental substance use. Research shows that these youth are at higher risks of housing instability; however, little is known about their housing experiences, from their perspective. This study explored the housing experiences of youth affected by parental substance abuse. PARTICIPANTS AND SETTING Fourteen African American young adults ages 18 to 24 years old who identified having at least one biological parent with a history of substance use participated in this study. The study is based in Baltimore, MD, USA; an urban city with one of the highest rates of drug overdose and substantial disadvantage. METHODS In-depth interviews were conducted among fourteen young adults (18-24) affected by parental drug use to discuss their housing experiences throughout childhood and adolescence. Five research team members developed a codebook, double coded all transcripts and analyzed inductively using a qualitative content analytic approach. RESULTS Three themes emerged to characterize housing experiences: frequent housing transitions, repeated trauma exposures related to housing instability, and the lasting effects of housing instability. CONCLUSION The residual impacts of parental substance use have caused youth to experience the toxic stress and trauma associated with housing instability. It is important that young people have safe, stable and reliable housing to promote child health and normative development.
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Affiliation(s)
- Quiana J Lewis
- Johns Hopkins Bloomberg School of Public Health, Department of Population, Family and Reproductive Health, 615 North Wolfe Street, Baltimore, MD 21215, USA.
| | - Bianca D Smith
- Johns Hopkins Bloomberg School of Public Health, Department of Population, Family and Reproductive Health, 615 North Wolfe Street, Baltimore, MD 21215, USA
| | - Asari Offiong
- Johns Hopkins Bloomberg School of Public Health, Department of Population, Family and Reproductive Health, 615 North Wolfe Street, Baltimore, MD 21215, USA
| | - Morgan Prioleau
- Johns Hopkins Bloomberg School of Public Health, Department of Population, Family and Reproductive Health, 615 North Wolfe Street, Baltimore, MD 21215, USA
| | - Terrinieka W Powell
- Johns Hopkins Bloomberg School of Public Health, Department of Population, Family and Reproductive Health, 615 North Wolfe Street, Baltimore, MD 21215, USA
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