Abstract Adverse Childhood Experiences Research Articles

LINKING ACES TO LIFE APPRAISAL AMONG OLDER WOMEN IN CORRECTIONAL CUSTODY

Abstract Adverse Childhood Experiences (ACEs), forgiveness, social support, and valuation of life were assessed for older women (45 years of age and older; N = 157) and younger women (those less than 45 years of age: N = 386) in custody in Oklahoma. The Model of Developmental Adaptation led to a path analysis with positive valuation of life or the developmental outcome regressed on proximal influences assessed by mediating variables, social provisions, and forgiveness, and these on the distal predictor, adverse childhood experiences. All endogenous measures were controlled for age, race, marital status, education, and crime type. Using Mplus 8.8 and an estimator that provides parameter estimates and a chi-square test statistic robust to non-normality, the study found that the model fit well for both age group. For the older women, 41% of the developmental outcome, positive valuation of life was explained; whereas for the younger women, 30% was explained. In addition, the standardized path from ACEs to Forgiveness not significant for either the younger or older women. However, for the younger women, ACEs was negatively associated with social provisions (β = -.109, p = .035). In addition, a significant indirect effect was found for the path from ACEs to valuation of life through social provisions (-.03, p = .026, one-tailed). Results have implications relative to how forensic psychologists, correctional case managers, and social workers support the mental health needs of women aging-in-custody. Further discussion will highlight strategies to reduce the impact of ACEs and improve quality-of-life.

AGE INVARIANCE IN THE FACTOR STRUCTURE OF ADVERSE CHILDHOOD EXPERIENCES ACROSS THE LIFESPAN

Abstract Adverse Childhood Experiences (ACEs) are associated with negative health and well-being across the adult life span. However, it is unclear whether measures of ACEs are equally predictive for adults of differing ages. Using responses from 125,212 adults on the 11-items in the ACEs Module from the 2020 Behavioral Risk Factor Surveillance System (BRFSS), we conducted both an exploratory factor analysis (EFA) and confirmatory factor analysis (CFA). Our EFA identified three interpretable factors, including a 3-item sexual abuse factor (α = .80), a 3-item physical/emotional abuse factor (α = .69) and a 5-item household dysfunction factor (α = .64). Results of our CFA supported the 3-factor solution, X2 (DF = 11) = 14.289, p < .001. A series of 1-way ANOVAS examined age differences in childhood adversity, where middle aged adults reported experiencing more sexual abuse relative to younger and older adults, and younger adults reported experiencing more physical/emotional abuse and household dysfunction compared to middle-aged who reported more than older adults. Additional analyses examined the influence of adverse childhood experiences on physical and mental health outcomes, including depression. Our analyses highlight the persistent effect of ACEs across the lifespan and identify a need for intervention resources for younger and middle-aged adults in order to mitigate effects of ACEs at late life.

Supportive Relationships with Trusted Adults for Children and Young People Who Have Experienced Adversities: Implications for Social Work Service Provision

Abstract Adverse childhood experiences encompass both direct harm, such as abuse and neglect, and indirect harm via family issues, including parental substance abuse and mental illness. They create significant risks for problems in later life, including mental health problems, substance abuse, interpersonal violence and self-harm. Due to these enduring and damaging consequences, interventions are essential to prevent or mitigate impact. One form of support is the role played by trusted adults in the lives of vulnerable children and young people. Employing a scoping study methodology, this article examines the role of the trusted adult and explores implications for social work agencies and practitioners. Whilst the idea of a supportive relationship may reflect the social work value base, there can be legal, procedural and bureaucratic barriers to directly providing such relationships in the child and family social work workforce. However, other adults associated with formal services such as teachers and youth workers, as well as extended family and community members may potentially be able to do so. Social workers can assist by becoming recruiters and facilitators of supportive adults for children and young people from their wider family or community and by partnering with organisations to stimulate provision of such services.

ADVERSE CHILDHOOD EXPERIENCES AND DEPRESSIVE SYMPTOMS AMONG RACIALLY/ETHNICALLY DIVERSE OLDER ADULTS IN THE US

Abstract Adverse childhood experiences (ACEs) and depression are major public health concerns. However, few studies have examined the relationship between ACEs and mid- and late-life depression among racially/ethnically diverse groups. We explore this relationship among U.S. racially/ethnically diverse community-dwelling midlife and older adults (≥50 years of age). Guided by ACEs and Minority Stress Frameworks, we used general linear models to examine this relationship with data from Wave 3 of the National Social Life, Health, and Aging Project. We created an ACEs composite ranging from 0 to 7 (e.g., violence, health, poverty) and assessed the role of individual ACEs on depressive symptoms (CES-D). Final adjusted models (n:1424) included key demographic, health (e.g., chronic disease), social (living alone, social isolation, loneliness), and minority stress factors (e.g., limited access to healthcare and treatment, perceived discrimination). Results indicated that higher composite score ACEs (particularly childhood violence and poor health) were positively associated with higher levels of depressive symptoms. We found no interactions between race/ethnicity and ACEs. Our results suggest that ACEs contribute to the presence and severity of depressive symptoms into mid- and late-life adulthood. Consistent with Minority Stress Framework, common life-course stressors for minoritized groups may explain a lack of significant interactions in our models. Future research should explore the association of ACEs and other important health outcomes in diverse midlife and older adults. Finally, research is needed to examine if and how culturally appropriate depression interventions can be adapted to address the role of ACEs in later life health.

ADVERSE CHILDHOOD EXPERIENCES (ACES) AND PARTICIPATION IN ROUTINE HEALTH SCREENING AMONG OLDER INDIVIDUALS

Abstract Adverse Childhood Experiences (ACEs) are a collective term used to define traumatic events before the age of 18. Individuals with ACEs are at risk for various negative health behaviors and chronic diseases. Routine screenings help in early detection of the disease and minimize the impact of the disease, disability, early death, and higher medical costs. Research on ACEs focusing exclusively on older population has received inadequate attention. Additionally, it is not clear whether different types of childhood adversities impact older individuals to participate in routine health screenings. This study included 3997 individuals above 65 years from the 2015 Texas Behavioral Risk Factor Surveillance System (BRFSS) to examine the prevalence of ACEs and their health screening practices. The dependent variable was participating in routine health checkup in the past year and 8 ACEs were the independent variables where gender, age, race, and having a personal doctor were controlled. Logistic regression models showed that prevalence of four ACEs (Physical, sexual, and emotional abuses and parental divorce/separation) were likely to reduce older individuals’ participation in routine checkup in the past year. Similarly, older individuals with personal doctor were twice more likely to visit for routine checkup compared to those without personal doctor. Lastly, older Black individuals were less likely to participate in routine checkup than their White counterparts. This study provided preliminary results to consider the impact of specific ACEs in routine health screening behaviors among older individuals. Future research might benefit from longitudinal study examining causal relationship between ACEs and health behaviors.

Adverse childhood experiences and burn pain: a review of biopsychosocial mechanisms that may influence healing

Abstract Adverse childhood experiences (ACEs) affect over half of the adults in the United States and are known to contribute to the development of a wide variety of negative health and behavioral outcomes. The consequences of ACE exposure have been studied in patient populations that include individuals with gynecologic, orthopedic, metabolic, autoimmune, cardiovascular, and gastrointestinal conditions among others. Findings indicate that ACEs not only increase risks for chronic pain but also influence emotional responses to pain in many of these individuals. A growing body of research suggests that these effects may be the result of long-lasting changes induced by ACEs in neurobiological systems during early development. However, one area that is still largely unexplored concerns the effects of ACEs on burn patients, who account for almost 450,000 hospitalizations in the United States annually. Patients with severe burns frequently suffer from persistent pain that affects their well-being long after the acute injury, but considerable variability has been observed in the experience of pain across individuals. A literature search was conducted in CINAHL and PubMed to evaluate the possibility that previously documented ACE-induced changes in biological, psychological, and social processes might contribute to these differences. Findings suggest that better understanding of the role that ACEs play in burn outcomes could lead to improved treatment strategies, but further empirical research is needed to identify the predictors and mechanisms that dictate individual differences in pain outcomes in patients with ACE exposure and to clarify the role that ACE-related alterations play in early healing and recovery from burn injuries.

Adverse childhood experiences

Adverse childhood experiences (ACEs) refers to traumatic experiences suffered by children which can have a long-term impact into adulthood. An understanding of early childhood experiences and the impact these can have helps educators meet the needs of children in their care, and influence their outcomes in later life.

Insights from Expanded Adverse Childhood Experiences Screening in a Hospital-Based Outpatient Psychiatry Service.

Adverse childhood experiences (ACEs) are associated with poor mental health in adulthood. Comprehensive prevalence data encompassing all 10 ACE questionnaire items has not previously been described in a hospital-based outpatient psychiatric clinic. This study assessed the prevalence of 10 ACEs in such a clinic and correlated ACEs with indicators of case severity. For 252 patients newly evaluated in an urban clinic, a retrospective chart review was completed and data was collected on ACE questionnaire responses, psychiatric, substance-related, and medical diagnoses, psychiatric hospitalizations, suicide attempts, and suicide and violence risk. Patients in the clinic had an average of 3.4 ACEs, higher than national community sample averages of 1.6. The percentages of patients with at least one, two, and four ACEs were 82% (n = 207), 68% (n = 172), and 42% (n = 106) respectively (compared with 61%, 38%, and 15% nationally). ACEs had statistically significant correlations with an increased number of psychiatric diagnoses, substance use disorders, medical illnesses, suicide attempts, and suicide risk level. This study demonstrated that patients seeking psychiatric care from a hospital-based outpatient clinic are likely to be traumatized to a degree far exceeding what is typical in the general population. While a high prevalence of ACEs in a psychiatric population is an expected finding given the literature to date, this is the first study presenting data on the prevalence of ACEs in such a hospital-based community clinic. Additionally this study reinforces prior research correlating childhood adversity and case severity.

ACE awareness in school nursing – becoming a trauma-informed service

Adverse childhood experiences (ACEs) can have a serious impact on children and young people's mental health and wellbeing, as well as affect their future. Caroline Parker explains why ACE awareness is essential for school nurses and shares her experience of developing training.

Applying an Advocating Student-Environment Lens to Foster Protective Factors: School Counselors’ Role in Buffering ACEs

ABSTRACT Adverse Childhood Experiences (ACEs) have the potential for detrimental effects on students’ mental, emotional, and physical well-being. However, Positive Childhood Experiences (PCE) and Protective Factors (PF) can potentially buffer the impact of ACEs. School counselors can apply an Advocating Student Environment theoretical lens to prioritize constructs that are strong predictors to fostering student success. Thus, school counselors can prioritize evidence-based interventions, organized and offered within this article using two detailed tables, that have been empirically supported to bolster PCE and PFs. These interventions can be delivered through a Multi-Tiered System of Support (MTSS) approach to alter oppressive systems or support student resiliency and success.

The Influence of Childhood Trauma and Masculine Ideology on Teacher Ratings of Student Risk Behavior

Masculine ideology and adverse childhood experiences (ACEs) are associated with student risk behaviors. With data from a sample of eighth-grade students, this study used hierarchical linear regression to examine the relationships between household ACEs, masculine ideology, and teacher-reported student risk behaviors. Results indicated that household ACEs were associated with higher academic and social risk behavior, while greater endorsement of masculine ideology was associated with higher academic risk behavior. We discuss implications for research and practice.

Determinants of Poor Health among Workers in Criminal Justice, Community and Social Services, and Healthcare: Adverse Childhood Experiences, Workplace Trauma Exposure, and Gender Differences

Adverse childhood experiences and workplace trauma exposure are associated with poor health. However, their differential impacts by gender are difficult to assess in studies of organizations with gender imbalances (e.g., law enforcement officers are more likely men whereas social workers are more likely women). Using a community-based participatory research framework, this study examines trauma exposure, mental and physical health, and substance use in an occupationally diverse sample (n = 391). Trauma exposure was high and associated with poor health. Even though women experienced more adversity, they were often more resilient than men. Implications for trauma-informed workplaces are discussed.

Associations of Adverse Childhood Experiences with Executive Function and Brain-Derived Neurotrophic Factor

Adverse childhood experiences (ACEs) may predict markers of neurocognitive performance (i.e., executive function; EF) and brain health/plasticity (i.e., brain-derived neurotropic factor; BDNF). This pilot examined the magnitude of effects between: 1) ACES and EF performance, 2) ACEs and BDNF levels, and 3) EF performance and BDNF levels. We hypothesize that higher ACEs will be associated with poorer EF scores and lower BNDF levels and that lower EF scores will be associated with lower BDNF levels. Given the pilot nature of the study, an emphasis is placed on effect size vs. significance. Participants were 36 middle-aged women enrolled in the NICE SPACES trial (age=31.4 years, BMI=34.2, racially minoritized=37.9%). ACES were quantified using the 10-item Adverse Childhood Experiences Scale. EF was measured using the fluid cognition composite from the NIH Toolbox – Cognition Battery. BDNF was estimated using proBDNF levels estimated from serum collected via venipuncture. Higher ACEs levels were not directly associated with EF scores (b = 0.03, p = .854); but did show a meaningful negative beta coefficient with BDNF levels (b = -0.34, p = .053). EF scores and BDNF showed a positive coefficient that did not reach significance (b = .26, p = .122). In a modest pilot of middle-age women, higher ACEs were associated with lower BDNF, indicating greater adversity in childhood is linked to lower neurotrophins levels in adulthood. The lower BDNF levels may help explain poorer performance on cognitive tasks. Larger follow-up studies in more powered samples are warranted given the size of detected coefficients.

Childhood Adversity Across the Lifespan: Assessing the Relationship Between ACEs and Subjective Cognitive Decline

Adverse childhood experiences (ACEs) have long-term impacts on health throughout the life course. Emerging research found that 3+ ACEs are associated with increased risk of cognitive impairment, nearly 11 times more than those who have not experienced childhood adversity. This study further investigates the ACEs-SCD relationship using data from the 2011 Behavioral Risk Factor Surveillance System (BRFSS). Seven ACE questions were asked of respondents in California, Washington, and Wisconsin (n=5,898, aged 55+); SCD was measured as experiencing progressive confusion or memory loss in the last 12 months. A series of logistic regressions were run to separately model the presence of ACEs and ACE score on SCD. Fourteen percent reported SCD, with 65.4% of those reporting 1+ ACE. More SCD respondents reported 4+ ACEs (10.8%) than non-SCD respondents (4.8%). The most frequently reported ACEs among those with SCD were psychological abuse (34.9%) and substance abuse in the household (30.5%). Regression results showed greater SCD risk with increased ACE scores, up to 2.90 odds of SCD for 4+ ACEs compared to 0 ACEs (p<.0001). Those reporting physical abuse and sexual abuse had the greatest odds (1.75 & 1.70, p<.0001) of SCD. Findings demonstrate a strong association between childhood adversity and SCD, with physical and sexual abuse placing individuals at greatest risk. Results show possible pathways to which ACEs can lead to cognitive impairment. Findings implicate the importance of considering a lifespan perspective in childhood adversity and family violence work and the importance of considering early-life adversity when assessing risk for cognitive impairment.

The Use of Advanced Integrative Therapy with C-PTSD and Intergenerational Trauma Transmission

Complex posttraumatic stress disorder (C-PTSD) and adverse childhood experiences (ACEs) pose health problems in the United States, and intergenerational relational trauma plays a role in the continuation and transmission of these issues. Advanced Integrative Therapy (AIT), a novel treatment, was used to treat a case of C-PTSD. The client’s chief concern was a flare-up of anxiety, relational distress, and fibromyalgia that occurred when they (chosen pronoun) accepted custody of their nephew. Over a span of nine 90-minute sessions, the clinician assessed progress using the PTSD Checklist for DSM-5 (PCL-5; Weathers et al., 2013) to measure PTSD symptoms; the International Trauma Questionnaire (ITQ; Cloitre et al., 2018), which measures C-PTSD symptoms according to the criteria of the World Health Organization (WHO) International Classification of Diseases, 11th revision (ICD-11); the Child-Parent Relationship Scale (CPRS; Pianta, 1992), which measures connection and conflict in the caregiver-child relationship; and the Subjective Units of Distress (SUD) scale (Wolpe, 1969), which rates the client’s current level of distress or discomfort. The clinician also used the self-report questionnaire Helpful Aspects of Therapy (HAT; Llewelyn et al., 1988) and the Change Interview (CI) method (Elliott et al., 2001) to measure client experience and perspective. After treatment with AIT, the client no longer met criteria for C-PTSD and showed dramatic improvement in intergenerational relationship satisfaction. In addition, there was a rapid reduction of hard to eradicate C-PTSD symptoms as well as reduction in the quantity and intensity of fibromyalgia induced pain. Use of AIT with caregivers could interrupt the transmission of intergenerational trauma thereby reducing or preventing ACEs by increasing emotional regulation and resilience.

Adverse Childhood Experiences and Forensic Typologies: Getting Specific about Trauma among Institutionalized Youth.

Adverse childhood experiences (ACEs) are linked to various conduct and behavior problems within juvenile delinquents, but fewer studies focused on these associations among specific forensic typologies of offending. Utilizing data from 3382 institutionalized delinquents in Texas, logistic regression models indicated multiple associations between ACEs and forensic typologies in both adjusted and unadjusted models, with sexual abuse and physical abuse emerging as the most consistent and robust predictors. Supplemental sensitivity models confirmed the associations between sexual abuse and physical abuse among youth who fit multiple forensic typologies. Models fared poorly at identifying youth who are engaged in fire setting. Implications for total and singular ACEs are discussed, along with how those relate to more clinically meaningful, forensic forms of juvenile delinquency.

The Differential Contribution of Adverse Childhood Experiences and Perceived Discrimination on Substance Use among Hispanic Emerging Adults

ABSTRACT Adverse childhood experiences (ACE) are widely documented risk factors for substance use among Hispanic emerging adults. Studies seldom examine whether distinct ACEs differentially relate to substance use in emerging adulthood, and if said association varies in the context of additional stressors disproportionately experienced by Hispanic people. This examination is necessary for understanding the etiology of substance use disorders and related outcomes among Hispanic individuals. Using a sample of Hispanic emerging adults, the goals of this study were two-fold. First, it examined differences in substance use between subgroups of varying ACEs. Second, it assessed whether substance use in the presence of discrimination differed between ACE subgroups. Latent class analysis identified two emerging ACE subgroups: [1] Parental Separation and [2] Physical & Emotional. On average, individuals in the Physical & Emotional subgroup endorsed a higher likelihood of tobacco, cannabis, and illegal drug use than those in the Parental Separation subgroup. For the latter, the likelihood of binge drinking was higher than that of the Physical & Emotional subgroup if they also perceived discrimination in emerging adulthood. These findings highlight the importance of considering the intersection of multiple social determinants of health for understanding the lifetime risk of substance use among Hispanic individuals.

Adverse Childhood Experiences (ACEs): Development of an ACEs Knowledge Scale.

Adverse childhood experiences (ACEs) negatively impacting children's health and later in their lives warrant necessity to educate nursing students about ACEs. The purposes of this study were to evaluate (a) nursing students' understanding of key concepts of ACEs using the ACEs Knowledge Scale (AKS) and (b) psychometric properties of the AKS. A survey using AKS was conducted with randomly selected student participants (n = 344) to evaluate students' understanding of ACEs knowledge. Empirical validation of the AKS included content validity using Content Validity Index (CVI), reliability, and construct validity analyses. The results showed students in the Bachelor of Science in Nursing (BSN) program had increased knowledge of ACEs over pre-nursing students, and the BSN graduating students had increased knowledge related to trauma-informed care and building resilience. There were no significant differences in ACEs knowledge between Family Nurse Practitioner (FNP) and BSN students. Evaluation of psychometric properties of AKS revealed S-CVI/Ave=0.912, indicated excellent content validity based on the expert panel's ratings. Cronbach's alpha coefficient = .84 for the overall instrument indicated good reliability. Factor analyses were employed, showing that the 5-factor model gives good fit indexes, supporting the hypothesized factor structure of five key concepts. The AKS has showed promising implications to future research, nursing education, and nursing practice.

Abstract P222: Impact Of Adverse Childhood Experiences On Ambulatory Blood Pressure Profiles In Adolescence

Adverse childhood experiences (ACEs) include exposure to abuse (verbal and physical), neglect, and household dysfunction during childhood. ACEs have long-lasting health impacts including increased risk for cardiovascular disease (CVD) and hypertension in adulthood. However, it is not clear how ACE exposure impacts CVD risk earlier in the life course, particularly in adolescence. To address this gap in knowledge, in this study we hypothesized that ACE exposure is associated with abnormal ambulatory blood pressure (ABP) profiles in adolescents, with an increased incidence of ambulatory hypertension phenotypes that have normal casual clinic BP [e.g., masked hypertension (MH) or blunted nocturnal dipping (BND)]. We utilized 24-h ambulatory BP monitoring (ABPM; Spacelabs) and casual clinic BP to construct a profile of adolescents with and without ACEs. Abnormal ABP profiles included the following categories: ambulatory hypertension (AH, elevated ABP and casual clinic BP ≥95 th percentile for age, sex, and height), white-coat hypertension (WCH, elevated casual clinic BP with normal ABP), MH (normal casual clinic BP with elevated ABP), or BND (drop in ABP &lt; 10% during sleep). This study included 78 male and female adolescents (median age=16) recruited from Children’s of Alabama Pediatric Clinics. Exclusion criteria included known CVD and antihypertensive medication. Participants recorded wake and sleep times in a diary. Based on the ACE questionnaire, 51 (65%) of adolescents experienced at least 1 ACE. The prevalence of abnormal ABP profiles was similar between the group with ACE exposures vs. the group without ACE exposures (34% vs. 36%; P =0.87). In participants with ACE exposure (n=51), 9% had AH, 6% had MH, 19% had WCH, 43.1% had systolic BND and 22% had diastolic BND. In participants without ACEs (n=27), 4% had AH, 4% had MH, 29% had WCH, 37% had systolic BND and 15% had diastolic BND. Further analysis with covariates are necessary. These results suggest that adolescents with ACEs have similar prevalence of abnormal ABP overall, but higher prevalence of individual ABP phenotypes such as AH, MH, and BND compared to adolescents without ACEs.

How and why do educational psychology services engage with an ACE-informed approach?

ABSTRACT Adverse childhood experiences (ACEs) and related approaches are receiving increasing focus from education policy makers and educational psychologists. However, the extent to which ACEs research and theory can be used to inform practice continues to be a topic for debate. The present paper explores the development of ACE-informed practice within two UK local authority educational psychology services, through use of focus groups and interviews with educational psychologists. Rationale, facilitators and barriers to the development of current ACE-informed practice are reported. Implications for educational psychology practice, including consideration of risk and reliance factors, the importance of consistent implementation of approaches, and future research are also considered.