Domínios latentes do instrumento Experiências Adversas na Infância Pediátrico e Rastreador de Eventos de Vida Relacionados (PEARLS-BR) e saúde infantil em uma amostra brasileira: um estudo de análise fatorial confirmatória e correlação

Centers for Disease Control and Prevention Investments in Adverse Childhood Experience Prevention Efforts

BackgroundResearch examining the connections between individual adverse childhood experiences (ACEs) and how groupings of interrelated adversities are linked with subsequent health is scarce, limiting our understanding of risk during a period of rapid expansion of ACE screening in clinical practice. The study objective was to conduct a psychometric analysis to derive latent domains of ACEs and related life events and assess the association between each domain and health outcome.MethodsParticipants (3 months-11 years) were recruited from the University of California San Francisco Benioff’s Children Hospital Oakland Primary Care Clinic. Children were screened with the Pediatric ACEs and Related Life Events Screener (PEARLS) (n = 340), which assessed 17 total ACEs and related life events, including forms of abuse, household challenges, and social risks. Domains were constructed using confirmatory factor analysis and associations between the three identified domains and 14 health outcomes were assessed using multivariable linear and logistic regression models.ResultsThree PEARLS domains were identified: Maltreatment (ω = 0.73, ɑ=0.87), Household Challenges (ω = 0.70, ɑ=0.82), and Social Context (ω = 0.55, ɑ=0.70). Measurement invariance was supported across both gender and screening format. All domains were associated with poorer general and behavioral health and stomachaches. Maltreatment and Social Context were additionally associated with eczema while only Social Context was associated with increased odds of reporting headaches and somatic symptoms.ConclusionIn an underserved, urban west-coast pediatric population, the PEARLS found three adversity domains of Maltreatment, Household Challenges, and Social Context that all had an independent statistically significant association with poorer child health. The results provide a timely and more nuanced representation of risk that can inform clinical practice and policy using more targeted resources and interventions.

Background: Many studies demonstrated the relationship between adverse childhood experiences (ACEs) and diminished health functioning in adulthood. A growing literature has shown that positive childhood experiences (PCEs) co-occurring with ACEs reduce the risks for negative outcomes. Objective: The aim was to investigate how ACEs and PCEs are simultaneously associated with health outcomes in adulthood, including self-rated health, physical and mental health outcomes, and health-risk behaviours. Methods: A panel sample of 4,847 Slovenian adults was used and the data were weighted to closely resemble the Slovenian population. A series of logistic regression analyses were performed to examine how ACEs and PCEs predict the risk of various health outcomes. Results: Significant associations, as measured by adjusted odds ratios, were found between higher ACEs exposure and each of the 16 health outcomes evaluated. Adjusting for above median PCEs attenuated the association between ACEs and 6 health outcomes (poor self-rated physical and mental health, depression, anxiety, suicide attempt, physical inactivity; OR for ≥ 4 vs. 0 ACEs, 1.48–9.34). Mirroring these findings, above median PCEs were associated with lowered odds of these 6 health outcomes after adjusting for ACEs (OR for above vs. below median PCEs, 0.46–0.67), but not with odds of physical health outcomes and most of the health-risk behaviours. Stratified analyses by ACEs exposure level showed that the association between PCEs and self-rated health remained stable across ACEs exposure levels, while the association between PCEs and mental health outcomes and physical inactivity varied across ACEs exposure levels. Conclusions: Our results suggest that above median PCEs attenuate the association between ACEs and poor self-rated health, mental health problems, and physical inactivity in later life, and are negatively associated with these health problems even in the concurrent presence of ACEs. Interventions to promote PCEs can help to reduce unfavourable long-term health outcomes following childhood adversity.

Positive and adverse childhood experiences and mental health outcomes of children

Objective: Adverse Childhood Experiences (ACEs) are traumatic exposures such as abuse, neglect, and household challenges that occur in childhood, and are associated with numerous psychiatric and cardiovascular conditions in adulthood. An expanded list of ACEs accounting for community-level stressors like experiences of racism, witnessing violence, bullying, foster care, and living in unsafe neighborhoods, have also been associated with poor health outcomes decades later. Black men may face structural inequities that increase the risk of exposure to ACEs, while also facing disparities in both cardiovascular health (CVH) and mental health outcomes. Despite these disproportionate risks, research examining household, family and community-level ACEs remain understudied in Black men. Given the importance of mental wellbeing to cardiovascular health, understanding how childhood adversity affects mental health warrants more study, particularly in Black men with unideal cardiovascular health. Methods: 149 Black men with low or moderate cardiovascular health participating in a community-based lifestyle intervention study, Black Impact, were surveyed for conventional ACEs, expanded ACEs, and validated measures of depressive symptoms, perceived stress, and social/emotional well-being. Linear regression models examined how ACEs predicted mental health measures. Logistic regression models examined ACEs’ effect on the odds of reaching clinically significant depression. Results: Each additional ACE was significantly associated with greater depressive symptoms, perceived stress, and social isolation, as well as lower emotional wellbeing and social functioning. An ACE score ≥ 4 was associated with 459% increased odds of reaching clinically significant depression (OR 4.59, 95% CI: 1.62 – 12.95) compared to 0-3 ACEs. Family and household-level ACEs were associated with all mental health measures. Community-level ACEs were associated with depressive symptoms, perceived stress and emotional wellbeing, but they were not associated with social functioning and social isolation. Conclusion: Increased ACEs predicted worse mental health symptoms across all measures in a sample of Black men with low or moderate cardiovascular health. Next steps include assessing the relationship between ACEs exposure and lifestyle intervention outcomes and exploring how to interrupt ACE-health outcome pathways to mitigate mental health and CVH disparities among Black men.

Population attributable fractions of adolescent health and well-being outcomes associated with adverse childhood experiences in a provincially representative sample in Ontario, Canada

Background: Different childhood experiences may affect adult health differently. Objective: To explore the association of different types of positive childhood experiences(PCEs) and adverse childhood experiences (ACEs) with risky behaviours and mental health indicators, andhow PCEs and ACEs are associated with health outcomes in the context of each other. Method: This was an exploratory cross-sectional online survey including 332 university students in Hong Kong. ACEs (abuse and household challenges), PCEs (perceived safety, positive quality of life, and interpersonal support), risky behaviours (smoking, binge drinking, and sexual initiation), and mental health indicators(depression, anxiety, loneliness, self-rated health, multimorbidity, meaning in life, and life satisfaction)were measured. Results: The multivariable logistic regression analysis indicated cumulative effects of PCEs in lowered risks of depression, anxiety, loneliness, as well as better self-rated health, life satisfaction, and meaning in life (p < .05), after adjusting for ACEs. Results also indicated that ACEs had an increasing relationship with poorer mental health indicators, such as anxiety, loneliness, and life satisfaction (p < .05), after adjusting for PCEs. There was also an adverse association between having ≥4 ACEs with smoking and binge drinking. In addition, each type of PCE and ACE was significantly associated with one or more risky behaviours and mental health indicators. Stratified results showed that PCEs had stronger associations with mental health indicators in participants with fewer ACEs. Furthermore, ACEs had stronger associations with mental health indicators in participants with more PCEs than in those with fewer PCEs. Conclusions: In this study, PCE was proven to be an independent protective factor against poor mental health after accounting for ACE. ACE was also proven to be an independent risk factor for poor mental health and risky behaviours. These findings suggest a crucial need for the active promotion of PCEs and the prevention of child maltreatment. The results of subtypes and stratifications can be taken into consideration when developing targeted interventions in the future. HIGHLIGHTS PCE is an independent protective factor against poor mental health after accounting for ACE. ACE is an independent risk factor for poor mental health and risky behaviours. PCEs and ACEs have different associations with health outcomes in the context of one another.

This cross-sectional study examined the association between adverse childhood experiences (ACEs) and history of frequent headaches (including migraine) among children 3-17years old using data from the 2016 and 2017 U.S. National Survey of Children's Health (NSCH). ACEs include abuse (physical, emotional, or sexual), parental divorce, death, mental illness, or addiction, and are linked to higher morbidity and mortality in adulthood. A relationship between ACEs and headaches exists among adults, but studies examining the relationship among children are lacking. To our knowledge, no studies have examined the link among children using NSCH data. The NSCH is a nationally representative survey of U.S. children's physical and emotional well-being aimed at understanding their health needs. Parental-reported information was collected on child history of headaches and 9 ACEs for the selected child. The survey collected information on 71,881 children in 2016 and 2017 out of which 61,565 were eligible for the study (age ≥3years and not missing data on history headaches). Children with missing values for headache, ACEs, or covariates (n=58,958) were excluded from the final analysis. We used multivariable logistic regression with survey weighting and adjusted for demographics and comorbidities (anxiety, depression, epilepsy, and brain injury) to examine the association between ACEs and headaches overall and stratified by gender. We further assessed the independent relationship between each ACE and headaches. In the current study, out of 61,656 children, 26,884 (48.6%) experienced at least 1 ACE and 3426 (6.5%) experienced 4+ ACEs. Overall, compared with children with no ACEs, the adjusted odds of headache were 1.34 times higher among children with 1 reported ACE (95% CI: 1.07, 1.68), 2.15 times higher among children with 2 ACEs (95% CI: 1.66, 2.80), 1.89 times higher among children with 3 ACEs (95% CI: 1.40, 2.53), and 3.40 times higher among children with 4+ ACEs (95% CI: 2.61, 4.43). Females with 3 and 4+ ACEs were somewhat more likely to report headaches compared to males with the same number of ACEs. Individually, no ACE was independently associated with history of headaches except for difficulty due to family's income (aOR=2.46, 95% CI: 1.98, 3.06). Experiencing one or more ACEs vs none was associated with higher risk of headaches in children, and difficulty due to family's income was the only ACE independently associated with headaches. Our findings support results of other studies on ACEs and headache in young adults and suggest that adverse ACE-related health outcomes begin earlier than previously recognized. Additionally, struggling due to low income may represent a constellation of chronic stressors that independently contribute to poor health outcomes in childhood as compared to other individual ACEs. Future research should examine the importance of specific ACE clusters and stressors during childhood.

Association of adverse and positive childhood experiences with subjective age: findings from 5759 Chinese young adults.

Adverse Childhood Experiences: Research, Effects, and Tools for Change

Network analysis of adverse and positive childhood experiences in a national sample of university students.

Background: Maternal adverse childhood experiences (ACEs) are believed to have negative consequences on offspring health. However, positive childhood experiences (PCEs) may be concurrent with ACEs, and little is known about how ACEs and PCEs transmit intergenerationally in the context of each other. Objective: To explore the independent effect of maternal ACEs and PCEs on offspring psychosocial well-being and how ACEs and PCEs are intergenerationally transmitted in their context. Method: Data were 2587 mother–child dyads in Anhui provinces of China. Mothers retrospectively reported their ACEs and PCEs, as well as provided demographic characteristics and their children’s psychosocial well-being. Logistic regression models were performed to explore the associations of maternal ACEs and PCEs with offspring psychosocial well-being. Results: Separate unadjusted logistic regression models showed that children with mothers reported high ACEs scores were more likely to have psychosocial challenges (total difficulties and prosocial problems), while children whose mothers reported high PCEs scores were less likely to have psychosocial challenges. When we added maternal ACEs and PCEs to a same model, we found that PCEs slightly neutralised the negative effects of ACEs on offspring’s total difficulties and prosocial problems. When stratified by sample, mothers with high PCE scores and higher maternal ACEs were related with a higher risk of offspring total difficulties; mothers with low levels of ACEs and high PCEs tend to report a lower risk of offspring total difficulties. Conclusions: Results suggest that PCEs are positively and intergenerationally transmitted. Results suggest that PCEs are positively and intergenerationally transmitted. More programme should be provided to increase maternal PCEs. When preventing the intergenerational transmission of ACEs, specific interventions should be provided to mothers with different levels of PCEs.

Preliminary findings for adverse childhood experiences and associations with negative physical and mental health and victimization in transmasculine adults

Adverse childhood experiences and health-related quality of life among women undergoing hysterectomy for uterine leiomyoma

Adverse childhood experiences (ACEs) have been associated with poor health outcomes in the general population. However, their impact on autistic youth remains unclear. The primary objective was to understand how childhood adversity is related to the general health, mental health, and physical health of transition-age autistic youth. Using data from the 2018-2021 National Survey of Children's Health, this cross-sectional study involved 2056 autistic youth aged 12-17. Logistic regression was employed to test the association between three measures of ACEs - individual ACEs, cumulative ACEs, and grouped ACEs based on contexts, and health outcomes of autistic youth. Our study observed a high prevalence of ACEs among autistic youth, with a substantially higher proportion experiencing multiple ACEs than their neurotypical peers. Individual ACEs were significantly associated with specific health issues. Cumulative ACEs demonstrated a clear dose-response relationship with health outcomes, with higher ACE counts increasing the likelihood of experiencing poor general health, mental health conditions, and physical health issues. Moreover, grouped ACEs associated with health differently, with community-based ACEs being particularly linked to general health status, mental health conditions, and physical health conditions, while family-based ACEs correlated more with more severe mental health conditions and being overweight. These findings collectively emphasize the importance of addressing ACEs as a public health concern among transition-age autistic youth, highlighting the need for targeted interventions, prevention strategies, and support services to mitigate the negative impact of ACEs on the overall well-being of this growing community.