Accumulation Of Adverse Childhood Experiences Research Articles

Framework and effects of the life story work based group intervention ANKOMMEN for adolescents in residential care in Germany. A qualitative analysis of interviews with participants

Adolescents in out-of-home care are a high-risk population due to their accumulation of adverse childhood experiences. Furthermore, out-of-home placement itself is a critical life event. Life story work (LSW) is a method for coping with critical life events. However, the need for a high amount of resources makes its implementation in care settings difficult. To improve the accessibility of LSW in residential care, the ANKOMMEN (English “Arriving”) intervention was developed as a manualized and cost-efficient group intervention. This study aims to explore the experiences of adolescents who took part in the intervention in order to examine how participation benefited them and what contributed to these beneficial effects. For this reason, we analyzed n = 48 individual interviews with adolescents after completing the intervention. The focused interview analysis method was used to transcribe and code the interviews. The qualitative analyses revealed that the framework of the intervention helped the participants to open up and to process parts of their history within the group. Moreover, the group setting was a major contributory factor to the positive effects of the intervention by encouraging the participants to exchange their experiences, through mutual peer support and the normalization of adverse thoughts and feelings. Furthermore, participation in the intervention increased self-esteem and self-efficacy in some participants. It contributed to the improvement of positive relationships, helped clarify placement associated events, thoughts and feelings, and improved the acceptance of the placement. Further research is needed to explore these findings and thus widen the range of application of LSW.

Agency & Identity Negotiations of “Good DNA” by Children with Incarcerated Parents Amidst Stigmatizing Mental Health Structures: A Culture-Centered Analysis

ABSTRACT Children with incarcerated parents (CIP) face higher burdens of mental illness owing to an accumulation of adverse childhood experiences (ACEs) marked by racialized and classed stigma. Utilizing instruments co-created by our CIP advisory board youth within a broader Youth Voice project, semi-structured in-depth interviews were conducted with 30 CIP, forming the primary data set for analysis within the present manuscript, in addition to two advisory board focus groups and 21 questionnaires. Drawing upon the culture-centered approach (CCA), this study explores CIP’s articulations of agency and positive identification, including narratives of strength, survival, and “good DNA” in making meaning of mental health experiences. Demonstrating a complex interplay of silence and voice, CIP agentically reframe mainstream narratives about problematic behavior as overt responses to inadequate structural support, challenge notions of the absent incarcerated parent, engage in the praxis of retailoring state mental health resources to align with their lived experiences and participate as active content creators and storytellers within community media spaces.

Prevalence of adverse childhood experiences and their co-occurrence in a large population of adolescents: a Young HUNT 3 study

PurposeStudies of adverse childhood experiences (ACEs) undertaken at the time of adolescence in the general population are not common. The aim of this study was to determine the prevalence and co-occurrence of the individual ACEs and sub-types of ACEs in a large population of adolescents.MethodsData were used from the Young Nord-Trøndelag Health (Young HUNT 3) study, a population-based study of young adolescents. ACEs were operational defined as sexual, physical and/or emotional abuse; physical and/or emotional neglect; and/or household dysfunction. Co-occurrence was measured as the accumulation of ACEs and as an overlap analysis.ResultsOf the 8199 evaluable adolescents, 65.8% had experienced at least one ACE and 28% of those had experienced more than one ACE. Household dysfunction was the most prevalent ACE subtype. The biggest overlaps among the three ACE sub-types were seen in those reporting neglect or abuse.ConclusionThere was a high degree of overlap between the three ACE sub-types and the individual ACEs, indicating that ACEs should be assessed together as a whole rather than separately. This study provides an opportunity to assess ACEs and their co-occurrences in relation to outcomes later in life.

Family Violence in Context: An Intergenerational Systemic Model

Family violence represents a major public health problem and a violation of human rights. Violent families engage in child maltreatment or intimate partner violence in response to horizontal stressors, such as the COVID-19 pandemic, and vertical stressors, including events in the family life cycle and changes in cultural contexts. Although family violence is often considered an individual problem, solutions require close examination of family structure, dynamics, and competence. The Beavers Systems Model for Family Functioning identified family groupings at risk of family violence. An emerging perspective on intergenerational transmission of violence from childhood neglect and abuse to elder abuse accounts for the accumulation of adverse childhood experiences and increasing risk of victimization or perpetration. An intergenerational systemic model identifies multiple contexts and levels for evaluating and treating family violence over the life span. Early identification and intervention facilitate prevention and rehabilitation. As families transcend adversity, they are able to realize post-traumatic growth and resilience. Recommendations for applications of the model are offered.

Adverse childhood experiences and incident coronary heart disease: a counterfactual analysis in the Whitehall II prospective cohort study

ObjectivesAdverse childhood experience is thought to be associated with risk of coronary heart disease, but it is not clear which experiences are cardiotoxic, and whether risk increases with the accumulation of adverse childhood experiences. MethodsParticipants were 5149 adults (72.6% men) in the Whitehall II cohort study. Parental death was recorded at phase 1 (median age in years 44.3), and 13 other adverse childhood experiences at phase 5 (55.3). We applied Cox proportional hazards regression with person-time from phase 5 to examine associations of adverse childhood experiences with incident coronary heart disease. We predicted hazard ratios according to count of the experiences, and examined dose-response effect. We finally estimated reduction of coronary heart disease in a hypothetical scenario, the absence of adverse childhood experiences. ResultsAmong study participants, 62.9% had at least one adversity, with “financial problems” having the highest prevalence (26.1%). There were 509 first episodes of coronary heart disease during an average 12.9 years follow-up. Among 14 adverse childhood experiences in a multiply adjusted model, “parental unemployment” showed the highest hazard of coronary heart disease incidence (hazard ratio; 95% confidence interval: 1.53; 1.16 to 2.02). No dose-response effect was observed (constant for proportionality in hazard ratio: 1.05, 0.99 to 1.11). Based on the estimates of final model, in the absence of childhood adversities, we estimated a 6.0% reduction in coronary heart disease (0.94; 0.87 to 1.01), but the confidence interval includes one. ConclusionAlthough individual adverse childhood experiences show some association with coronary heart disease, there is no clear relationship with the number of adverse experiences. Further research is required to quantify effects of multiple and combinations of adverse childhood experiences considering timing, duration, and severity.

Parental Separation - Is the Accumulation with Other Adverse Childhood Experiences the Main Burden? Analysis of a Representative Sample of the German Population

Adverse childhood experiences (ACEs) tend to co-occur. The more forms of childhood adverse are experienced, the higher are the psychological and physical impairments in adulthood. The present study therefore examines the extent to which the experience of parental separation is related to the risk of other forms of ACEs and the extent to which the accumulation of ACEs is related to impairment in adulthood. A cross-sectional analysis of a representative sample of the German population from the age of 18 onwards was performed (N=2466; mean age=49.5 years (18-93); f: 1368 (55.5%); m: 1098 (44.5%)). The demographic data were assessed by interview, the remaining data were collected by questionnaires. Current depressive and anxiety symptoms self-perceived somatic health and life quality were assessed, while ACEs were assessed retrospectively by the Adverse Childhood Experiences (ACE)-Questionnaire. Child maltreatment and mental illness of household members, substance abuse of household members, incarceration of household members and violence against the mother were more frequent when participants reported separation of parents. Parental separation was not associated with an increased rate of psychological impairment and, in women, physical impairment when no other forms of ACEs were present. Children and adolescents whose parents have separated more often experience other forms of ACEs than their peers. It seems to be this accumulation of ACEs that is associated with impairments in adulthood.

Responding to the accumulation of adverse childhood experiences in the wake of the COVID-19 pandemic: implications for practice

AbstractIn early 2020, the world as we knew it began to change dramatically and rapidly with the COVID-19 outbreak. Social distancing restrictions and lockdown measures have been the most effective course of action and an inarguably imperative approach at this time. However, in trying to keep the global population safe, social distancing measures unwittingly placed children already experiencing maltreatment and disadvantage in harm’s way. This paper will consider the evidence base which attests to the importance of considering theaccumulationof adversity when seeking to understand risk and impact of child maltreatment and disadvantage. Given the unique and unprecedented circumstances which have accompanied the COVID-19 outbreak, and the dearth of research pertaining to the impact of pandemics on child welfare, the paper draws on an emerging body of literature about the effect of natural disasters, conflict and significant global events on child maltreatment. The paper synthesises the research to date in order to call attention to the cumulative impact of the COVID-19 pandemic on children already experiencing abuse and neglect. The paper concludes with an outline of the implications for practice in the helping professions.

Adverse Childhood Experiences and Household Food Insecurity: Findings From the 2016 National Survey of Children's Health

Research has linked adverse childhood experiences to a host of negative health outcomes. The present study examines the link between individual and cumulative adverse childhood experience exposure and household food insecurity in a recent, nationally representative sample of children, and whether parent self-rated well-being attenuates these associations. Data from the 2016 National Survey of children's Health were analyzed in 2018 (n=50,212). Information concerning children's exposure to multiple forms of adversity, household availability of food, and parent self-rated well-being were available in the data. Multinomial logistic regression was performed to analyze the data. Findings suggest that the accumulation of adverse childhood experiences is associated with higher odds of food insecurity, with stronger associations between adverse childhood experience accumulation and moderate-to-severe food insecurity. Compared with no adverse childhood experience exposure, exposure to 3 or more adverse experiences corresponded to an 8.14-fold increase in the RR of moderate-to-severe food insecurity. Self-rated parent physical and mental well-being partially attenuated these associations. Policies aimed at minimizing adverse childhood experience exposure among children may have important collateral benefits in the form of reduced household hunger. Existing nutrition assistance programs may be enhanced by linking children and families to programs that bolster parent and child well-being; addressing community and family violence; and providing support for caregivers to prevent abuse, hardship, and exposure to the criminal justice system.

The Developmental Nature of the Victim-Offender Overlap

PurposeIt is well-established that victims and offenders are often the same people, a phenomenon known as the victim-offender overlap, but the developmental nature of this overlap remains uncertain. In this study, we drew from a developmental theoretical framework to test effects of genetics, individual characteristics, and routine-activity-based risks. Drawing from developmental literature, we additionally tested the effect of an accumulation of adverse childhood experiences (ACEs).MethodsData came from the Environmental Risk (E-Risk) Study, a representative UK birth cohort of 2232 twins born in 1994–1995 and followed to age 18 (with 93% retention). Crime victimization and offending were assessed through self-reports at age 18 (but findings replicated using crime records). We used the classical twin study method to decompose variance in the victim-offender overlap into genetic and environmental components. We used logistic regression to test the effects of childhood risk factors.ResultsIn contrast to past twin studies, we found that environment (as well as genes) contributed to the victim-offender overlap. Our logistic regression results showed that childhood low self-control and childhood antisocial behavior nearly doubled the odds of becoming a victim-offender, compared to a victim-only or an offender-only. Each additional ACE increased the odds of becoming a victim-offender, compared to a victim-only or an offender-only, by approximately 12%, pointing to the importance of cumulative childhood adversity.ConclusionsThis study showed that the victim-offender overlap is, at least partially, developmental in nature and predictable from personal childhood characteristics and an accumulation of many adverse childhood experiences.

Adverse childhood experiences and risk for suicidal behavior in male Iraq and Afghanistan veterans seeking PTSD treatment.

Adverse childhood experiences (ACEs) are associated with increased risk for suicide and appear to occur in disproportionately high rates among men who served in the U.S. military. However, research has yet to examine a comprehensive range of ACEs among Iraq/Afghanistan veterans with combat-related posttraumatic stress disorder (PTSD) or whether these premilitary stressors may contribute to suicidal behavior in this highly vulnerable population. A sample of 217 men entering a residential program for combat-related PTSD completed measures for ACEs, combat exposure, and lifetime suicidal ideation and attempts. The majority of patients had experienced multiple types of adversity or traumas during childhood/adolescence. In particular, 83.4% endorsed at least 1 ACE category and 41.5% reported experiencing 4 or more ACEs. When accounting for effects of deployment-related stressors, we further found that accumulation of ACEs was uniquely linked with thoughts of suicide or attempts among these patients. Namely, for every 1-point increase on the ACE Questionnaire, veterans' risk of suicidal ideation and attempts increased by 23% and 24%, respectively. This brief report provides initial evidence that veterans seeking treatment for combat-related PTSD often have extensive histories of premilitary stressors that may increase suicide risk beyond probable deployment-related traumas. (PsycINFO Database Record

The associations of cumulative adverse childhood experiences and irritability with mental disorders in detained male adolescent offenders.

BackgroundAdverse childhood experiences (ACEs) and psychiatric disorders are common in juvenile detainees. Emotional dysregulation resulting from cumulated ACEs may be characterized by symptoms of irritability. The present study examined whether the accumulation of ACEs, irritability, or both predicted mental disorders in incarcerated adolescents with and without controlling for one another and for socio-demographic factors.MethodsOne hundred thirty male detained juvenile offenders (aged 13.8–19.5 years) were assessed by structured clinical interviews and a self-reporting scale for irritability. Univariate and multivariate regression models were used to examine the shared and distinct associations of ACEs and irritability with psychiatric diagnoses.ResultsA total of 75 % of the participants reported more than one ACE. The ACE total score was positively related to self-reported irritability. The ACE total score predicted depressive disorders, suicidality, post-traumatic stress disorder (PTSD), and anxiety disorders. Irritability was positively related to depressive disorders, suicidality, disruptive behavior disorder (DBD), substance use disorder (SUD), and attention deficit hyperactivity disorder (ADHD). These associations remained significant in multivariate models.ConclusionsThis study provides evidence for the predictive impact of self-reported ACEs and irritability with regard to adolescent psychiatric disorders in young male inmates. Both variables differed in their predictive power for PTSD, internalizing, and externalizing disorders indicating the need for specific therapeutic interventions. Taking a close look at their trauma history seems to be of special importance for juveniles suffering from PTSD and anxiety disorders. For delinquent adolescents with DBD, ADHD and SUD, the training of emotion regulation techniques appears most promising. Approaches focusing on both, ACEs and emotion-focused contents may be implemented in the treatment of depressive disorders and suicidality.