Experiências Adversas na Infância Pediátrico e Rastreador de Eventos de Vida Relacionados (PEARLS-BR): prevalência e resultados de saúde em um contexto brasileiro

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

Children with intellectual disabilities experience unique developmental, social, and environmental challenges that intersect with adverse childhood experiences (ACEs) and positive childhood experiences (PCEs), shaping their psychosocial outcomes. While prior research has mainly examined single adversities or protective elements, the frameworks of ACEs and PCEs provide a broader understanding of their cumulative and interactive effects. However, these constructs remain underexplored in children with intellectual disabilities. This scoping review maps the range, conceptualization, and impact of ACEs, PCEs, and related concepts on psychosocial outcomes. Following the Joanna Briggs Institute (JBI) methodology, a search of PsycInfo, MEDLINE, CINAHL, Web of Science, and Google Scholar identified studies until October 2024. Two reviewers screened and extracted data using standardized criteria. Findings reveal variability in how ACEs and PCEs are defined and measured. ACE exposure, particularly the cumulative impact of multiple ACEs (polyvictimization), links to adverse psychosocial outcomes, including emotional (e.g., anxiety, depression, Post-Traumatic Stress Disorder), behavioral (e.g., aggression, conduct problems), and developmental (e.g., social and adaptive skill deficits) difficulties. PCEs—such as positive parent–child relationships, teacher–student support, and peer acceptance—mitigate risks, though impact varies by context. Intellectual disabilities severity and socioeconomic adversity shape associations. Further research is needed to inform the adaptation of ACE–PCE frameworks for children with intellectual disabilities.

Adverse Childhood Experiences (ACEs) are associated with long-term health risks, including behavioural, physical and mental health issues. However, there is limited data on the prevalence and impact of ACEs among school-age children in Thailand. To determine the prevalence of ACEs and their associations with behavioural and health outcomes in primary school Thai children. A cross-sectional study was conducted from July 2023 to June 2024, involving 399 primary school students aged 6-12 years, selected through stratified random sampling. Data were collected using the Paediatric ACEs and Related Life Events Screener (PEARLS) to measure ACEs, the Thai Youth Checklist (TYC) for behavioural assessments, and a health screening questionnaire for physical and mental health. The relationship between cumulative ACEs and health conditions was analysed. Among the 399 participants (median age: 9.5 years, IQR: 8-11), 48.7% of surveyed children reported experiencing at least one ACE. The most prevalent ACE was caregiver divorce or separation (33%), followed by neglect (9.3%) and domestic violence (8.3%). Children with four or more ACEs had a significantly increased risk of behavioural problems, including internalising problems (adjusted odds ratio [AOR] = 7.57; 95% CI: 2.54-22.64), externalising problems (AOR = 5.52; 95% CI: 1.82-16.79), and total behavioural issues (AOR = 8.65; 95% CI: 2.97-25.24). No significant association was found between ACEs and health conditions. Nearly half of the surveyed Thai primary school children experienced ACEs, and a graded association was found between the number of ACEs and behavioural problems. These findings underscore the need for early, strength-based interventions to reduce long-term risks. Primary prevention strategies should prioritise supporting families before adversity occurs.

Adverse childhood experiences (ACEs) are recognised as a strong risk factor affecting health outcomes. This systematic review seeks to synthesize evidence from global studies, investigating the associations of ACEs with the development of various health issues beyond childhood in Indigenous populations. Systematic review. We systematically searched for research articles published up to February 2024, in databases of peer-reviewed literature. We searched for articles on different types of ACEs recorded and their associated problematic health outcomes in different Indigenous populations across the world. Observational studies and administrative linkage study design were eligible for inclusion. Summary results of individual studies and variations of different ACE measuring tools are presented. We further explored the potential link between ACEs and various health outcomes by constructing an acyclic graph based on available evidence. We screened 2468 articles, and 56 were included in our review. Although tools for measuring ACEs were diverse, most of the studies used either the CDC-Kaiser study tool or tools by Bernstein et al. which were developed for the mainstream population. No Indigenous-specific tool was found that was used to assess ACEs in Indigenous populations. The studies assessed several types of ACEs, with sexual abuse and physical abuse being the most common. All the studies reported a significant association between ACEs and adverse health outcomes where mental health issues were more examined than physical health issues. As we found that there was no validated Indigenous-specific tool for the Indigenous population, it is crucial to develop ACE measurement tools tailored to Indigenous populations that can capture trauma events related to their unique history and cultural context. Considering the higher prevalence of several physical health problems, especially cardiovascular and metabolic diseases in this population, more research should be conducted to identify their links with ACEs.

Adverse childhood experiences (ACEs) are well-documented risk factors for poor social, behavioral, and physical health outcomes, yet their impact on U.S. Service Members has not been comprehensively reviewed. This systematic review, registered with PROSPERO and conducted in accordance with PRISMA guidelines, examined the health outcomes associated with ACE exposure in military populations. A search across eight databases identified 707 articles; 21 peer-reviewed studies met inclusion criteria after screening. Most studies focused on Army personnel, with smaller representations of Marines, Air Force, and mixed-Service groups; no studies specifically examined Navy or Coast Guard personnel. Findings indicate that Service Members report higher ACE exposure than civilians, with consistent associations to adverse behavioral and health outcomes that threaten individual well-being and mission readiness. Despite increasing recognition of ACE-related challenges, gaps persist in military-specific policy, education, and intervention strategies. Efforts to standardize ACE screening protocols across national and international military collaborations could further strengthen prevention and intervention approaches. Additionally, expanding research into cross-cultural military contexts would provide valuable insight into how ACEs manifest differently across diverse environments. These results underscore the urgent need for ACE-informed policies and practices in recruitment, training, and ongoing support to mitigate the long-term effects of ACEs and sustain the resilience and readiness of the force.

Adult correlates of adverse childhood experiences in Ukraine

Suicide is one of the leading causes of death, and the rates of suicidal ideation are higher among unwed mothers compared to their counterparts in the Republic of Korea. Adverse childhood experiences (ACEs) have been associated with negative health and behavior outcomes, including suicidal ideation. However, the impact of ACEs on suicidal ideation among Korean unwed mothers remains underexplored. The purpose of this study is to examine the relationships between ACEs and suicidal ideation in adulthood within a sample of 255 Korean unwed mothers. Logistic regression was used to examine the impact of both cumulative and specific ACEs on suicidal ideation in adulthood. The results showed that 34.1% of mothers reported suicidal ideation, 79.8% experienced at least one ACE, and 44.7% reported experiencing four or more ACEs, highlighting a significant level of risk. The number of ACEs was associated with increased odds of having suicidal ideation. Distinct effects of specific types and combinations of ACEs were also identified. Unwed mothers exposed to physical neglect, emotional neglect, or domestic violence were at heightened risk of suicidal ideation. These findings suggest that neglect and domestic violence are critical factors in identifying unwed mothers at risk for suicidal ideation and underscore the necessity of implementing trauma-informed practices to mitigate suicide risk.

IntroductionSocially excluded populations, defined by homelessness, substance use disorder, sex work or criminal justice system contact, experience profound health inequity compared with the general population. Cumulative exposure to adverse childhood...

Protective factors can build resilience and potentially moderate the long-term impact of adverse childhood experiences (ACEs). To better understand the role of protective factors, this study examines the relationship of two protective factors focused on safe, stable and nurturing relationships, ACEs, and self-reported mental and physical health outcomes among a representative adult sample from the South Carolina Behavioral Risk Factor Surveillance System. Protective factors were assessed as potential moderators of ACEs and poor self-reported physical and mental health in multivariate logistic regression analyses. Respondents exposed to four or more ACEs who grew up with an adult who made them feel safe and protected were less likely to report frequent mental distress or poor health. The use of protective factors may be an effective prevention strategy for ACEs and its associated outcomes and may serve as a mechanism to "break the cycle" of childhood trauma.

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.

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

ObjectiveThis study explores the links between negative childhood experiences and depression in older adults, focusing on how pensions and offspring support influence the relationship between adverse childhood experiences (ACEs) and the mental health outcomes of the elderly.MethodsData were obtained from the 2016, 2018, and 2020 China Longitudinal Aging Social Survey (CLASS). We used the ordinary least squares (OLS) method and moderation tests to analyze depression health outcomes.ResultsOlder adults with ACEs had worse mental health outcomes than those without ACEs. The ACEs of medical deficiency, parental absence, and hunger during childhood manifested as higher depression scores in old age. The heterogeneity regression results show that medical deficiency and hunger experiences have a more significant impact on the depression of elderly individuals in urban areas. In contrast, early experiences of parental absence have a greater effect on the depression of elderly individuals in rural areas. Regression results for moderating effects indicate that children’s support can effectively alleviate the impact of adverse childhood experiences on the depression status of the elderly; however, pensions and the number of friends do not play a positive moderating role.ConclusionACEs, pension, and offspring support were independently associated with older adults’ mental health problems, and the combination of ACEs and low offspring support was the most significant predictor of adverse health outcomes in old age, controlling for adult sociodemographic indicators. Enhancing supportive relationships between children and older adults may buffer the negative effects of early adversities on older adult well-being.

Adverse childhood experiences (ACEs) are linked to adverse health outcomes for adults and children in the United States. The prevalence of critically ill children who are exposed to ACEs is not known. Our objective was to compare the frequency of ACEs of critically ill children with that of the general pediatric population of Georgia and the United States using publicly available National Survey of Children’s Health (NSCH) data. The impact of ACEs on patient-reported outcome measures of emotional, social, and physical health in critically ill children is not known. We sought to determine whether a higher total number of ACEs was associated with poorer patient-reported measures of emotional, social, and physical health. We conducted a prospective cross-sectional study of children < 18 years of age who were admitted to a 36-bed free-standing, quaternary academic pediatric intensive care unit in Atlanta, Georgia from June 2020—December 2021. Parents of patients who were admitted to the pediatric intensive care unit completed a survey regarding their child’s ACEs, health care use patterns, and patient-reported outcome measures (PROMIS) of emotional, social, and physical health. Prevalence estimates of ACEs were compared with national and state data from the NSCH using Rao-Scott Chi-square tests. PROMIS measures reported within the PICU cohort were compared with population normed T-scores. The association of cumulative ACEs within the PICU cohort with patient-reported outcomes of emotional, social, and physical health were evaluated with a t-test. Among the 84 participants, 54% had ≥ 1 ACE, 29% had ≥ 2 ACEs, and 10% had ≥ 3 ACEs. Children with ≥ 2 ACEs had poorer anxiety and family relationship T-scores compared to those with ≤ 1 ACE. Given the high burden of ACEs in critically ill children, screening for ACEs may identify vulnerable children that would benefit from interventions and support to mitigate the negative effects of ACEs and toxic stress on emotional, social, and physical health.

BackgroundExperiencing multiple adverse childhood experiences (ACEs) is a risk factor for many adverse outcomes. We explore associations of ACEs with educational attainment and adolescent health and the role of family and socioeconomic factors in these associations.Methods and findingsUsing data from the Avon Longitudinal Study of Parents and Children (ALSPAC), a prospective cohort of children born in southwest England in 1991–1992, we assess associations of ACEs between birth and 16 years (sexual, physical, or emotional abuse; emotional neglect; parental substance abuse; parental mental illness or suicide attempt; violence between parents; parental separation; bullying; and parental criminal conviction, with data collected on multiple occasions between birth and age 16) with educational attainment at 16 years (n = 9,959) and health at age 17 years (depression, obesity, harmful alcohol use, smoking, and illicit drug use; n = 4,917). We explore the extent to which associations are robust to adjustment for family and socioeconomic factors (home ownership, mother and partner’s highest educational qualification, household social class, parity, child’s ethnicity, mother’s age, mother’s marital status, mother’s depression score at 18 and 32 weeks gestation, and mother’s partner’s depression score at 18 weeks gestation) and whether associations differ according to socioeconomic factors, and we estimate the proportion of adverse educational and health outcomes attributable to ACEs or family or socioeconomic measures. Among the 9,959 participants (49.5% female) included in analysis of educational outcomes, 84% reported at least one ACE, 24% reported 4 or more ACEs, and 54.5% received 5 or more General Certificates of Secondary Education (GCSEs) at grade C or above, including English and Maths. Among the 4,917 participants (50.1% female) included in analysis of health outcomes, 7.3% were obese, 8.7% had depression, 19.5% reported smoking, 16.1% reported drug use, and 10.9% reported harmful alcohol use. There were associations of ACEs with lower educational attainment and higher risk of depression, drug use, and smoking. For example, odds ratios (ORs) for 4+ ACEs compared with no ACEs after adjustment for confounders were depression, 2.4 (1.6–3.8, p < 0.001); drug use, 3.1 (2.1–4.4, p < 0.001); and smoking, 2.3 (1.7–3.1, p < 0.001). Associations with educational attainment attenuated after adjustment but remained strong; for example, the OR after adjustment for confounders for low educational attainment comparing 4+ ACEs with no ACEs was 2.0 (1.7–2.4, p < 0.001). Associations with depression, drug use, and smoking were not altered by adjustment. Associations of ACEs with harmful alcohol use and obesity were weak. For example, ORs for 4+ ACEs compared with no ACEs after adjustment for confounders were harmful alcohol use, 1.4 (0.9–2.0, p = 0.10) and obesity, 1.4 (0.9–2.2, p = 0.13) We found no evidence that socioeconomic factors modified the associations of ACEs with educational or health outcomes. Population attributable fractions (PAFs) for the adverse educational and health outcomes range from 5%–15% for 4+ ACEs and 1%–19% for low maternal education. Using data from multiple questionnaires across a long period of time enabled us to capture a detailed picture of the cohort members’ experience of ACEs; however, a limitation of our study is that this resulted in a high proportion of missing data, and our analyses assume data are missing at random.ConclusionsThis study demonstrates associations between ACEs and lower educational attainment and higher risks of depression, drug use, and smoking that remain after adjustment for family and socioeconomic factors. The low PAFs for both ACEs and socioeconomic factors imply that interventions that focus solely on ACEs or solely on socioeconomic deprivation, whilst beneficial, would miss most cases of adverse educational and health outcomes. This interpretation suggests that intervention strategies should target a wide range of relevant factors, including ACEs, socioeconomic deprivation, parental substance use, and mental health.

Adverse childhood experiences (ACEs) affect 22–75% of American young adults. ACEs are associated with adverse health outcomes that begin in young adulthood. Yet, scant research has examined if coping can mediate the relationship between ACEs and adverse outcomes. The current study determined if coping mediates the relationship between ACEs and body mass index (BMI), substance use, and mental health outcomes in young adults. A community sample of 100 White and 100 Black young adults 18–34 years of age participated in a cross-sectional study conducted via Zoom conferencing. Participants provided demographic data, height/weight, and completed measures of ACEs, coping, substance use, and mental health outcomes. Coping was measured using an established three-factor model consisting of adaptive, support, and disengaged coping. Structural equation modeling (SEM) examined the relationships of ACEs to outcomes as mediated by coping. Participants were predominantly female (n = 117; 58.5%) and mid-young adult (M = 25.5 years; SD = 4.1). SEM results indicated good model fit: (CMIN/df = 1.52, CFI = 0.94, RMSEA = 0.05 [90% CI = 0.03-0.07], SRMR = 0.06). Only disengaged coping mediated the ACE and substance use (β = 0.36, p = .008), smoking (β = 0.13, p = .004), and mental health (β=-0.26, p = .008) relationships. Disengaged coping styles may be a critical mechanism in developing adverse mental health and substance use outcomes among ACE-exposed individuals. Future ACE and health outcomes research should examine the role of coping. Interventions focusing on adaptive coping may improve the health of individuals exposed to ACEs.