Adverse Childhood Experience Data Research Articles

Adverse childhood experiences and multimorbidity of internalising and cardiometabolic conditions in an older-age population.

BackgroundTackling multimorbidity (ICM-MM) of internalising conditions (IC) and cardiometabolic conditions (CM) is key to improving the future of healthcare. Early life factors such as adverse childhood experiences (ACEs) have been linked to long term, poor mental and physical health conditions. AimsThis study investigated whether: 1) ACEs increase the risk of IC, CM and ICM-MM; 2) the effect of ACEs on risk of developing CM depends on the presence of IC and vice versa; 3) how risk differs by gender, socioeconomic status and ethnicity. MethodsIn UK Biobank, the Childhood Trauma Screener was used to identify 157,256 participants with ACE data. Electronic healthcare records (EHR) and interview data identified those with anxiety or depression (IC) and those with hypertension, obesity, type 2 diabetes, dyslipidaemia or chronic kidney disease (CM). Multivariate logistic regression models were employed to find associations between ACEs and IC, CM and ICM-MM. Covariates included age, gender, ethnicity, socioeconomic status, diet, alcohol intake, smoking behaviour and physical activity. ResultsAll ACEs significantly increase risk for IC (all ACEs, p = <2e-16). Emotional neglect, physical neglect and emotional abuse increase risk of CM (e.g. physical neglect, OR = 1.43, CF = 1.30-1.58, p = 1.88e-13). ACEs appear to increase IC and CM risk independently. ConclusionsThe effects of ACEs last well into adulthood and confer risk for IC and, sometimes, CM. ACE history should be included in routine primary care and the development of therapeutic interventions tailored to older adults with ACEs is key to reducing poor health.

Adverse Childhood Experiences Module Nonresponse: Behavioral Risk Factor Surveillance System, 2019 and 2021

IntroductionData on adverse childhood experiences (ACEs) are key to understanding their burden and informing prevention programs and strategies. Population-based surveys that collect ACEs data may be affected by item non-response. This study examines differences in non-response to the optional Behavior Risk Factor Surveillance System (BRFSS) ACEs module overall, by sociodemographic characteristics, year, and question. MethodsThe study used BRFSS ACEs Module data from 21 states in 2019 and 16 states in 2021. Weighted proportions and 95% confidence intervals (95% CI) of responders and non-responders to the ACEs module by year and sociodemographic characteristics, and percentages of non-responders for each question were calculated. Chi-square tests were used to assess statistically significant (p<0.05) differences. Analyses were conducted in 2023. ResultsIn 2019 and 2021, 1.2% (95% CI=1.1, 1.4) and 2.4% (95% CI=2.2, 2.5) of BRFSS participants were non-responders to the ACEs Module, respectively (p<0.01). Compared with responders, non-responders were more likely to be non-Hispanic Black (p=0.01) or non-Hispanic Asian (p=0.01), unemployed (p<0.01), have income <$15,000 (p<0.01), or report poor health (p<0.01). Non-response by question increased as the module progressed, and non-response was highest for sexual abuse questions. ConclusionsOverall, findings demonstrate that individuals are willing to respond to the ACEs module questions. Although low, non-response to the module increased from 2019 to 2021. Higher non-response for sexual abuse questions may be due to their sensitivity or potential survey fatigue due to placement at the end of the module. Higher non-response among racial/ethnic minorities and economically disadvantages groups highlight opportunities to improve existing surveillance systems.

Adverse childhood experiences and adult disease: Examining mediating pathways in the Hispanic Community Health Study/Study of Latinos Sociocultural Ancillary Study.

Adverse childhood experiences (ACEs) have been linked to adulthood chronic diseases, but there is little research examining the mechanisms underlying this association. We tested pathways from ACEs to adult disease mediated via risk factors of depression, smoking, and body mass index. Prospective data from adults 18 to 74 years old from the Hispanic Community Health Study/Study of Latinos and Sociocultural Ancillary Study were used. Retrospectively reported ACEs and hypothesized mediators were measured at Visit 1 (2008-2011). Outcomes of disease prevalence were assessed at Visit 2, approximately 6 years later. The analytic sample includes 5,230 Hispanic/Latino participants with ACE data. Statistical mediation was examined using structural equation modeling on cardiometabolic and pulmonary disease prevalence and reported probit regression coefficients with 95% confidence intervals (CIs). We found a significant association between ACEs and the prevalence of asthma/chronic obstructive pulmonary disorder (standardized β = .07, 95% CI [0.02, 0.12]). In the mediational model, the direct association was nonsignificant (β = .02, 95% CI [-0.04, 0.07]) but was mediated by depressive symptoms (β = .03, 95% CI [0.02, 0.04]). There were no associations between ACEs and the prevalence of diabetes and self-reported coronary heart disease or cerebrovascular disease. However, a small indirect effect was identified via depressive symptoms and coronary heart disease (β = .02, 95% CI [0.01, 0.03]). In this diverse Hispanic/Latino sample, depressive symptoms were found to be a pathway linking ACEs to self-reported cardiopulmonary diseases, although the effects were of small magnitude. Future work should replicate pathways, confirm the magnitude of effects, and examine cultural moderators that may dampen expected associations. (PsycInfo Database Record (c) 2024 APA, all rights reserved).

Characteristics of children and adolescents referred to specialist gender services: a systematic review

BackgroundIncreasing numbers of children/adolescents experiencing gender dysphoria/incongruence are being referred to specialist gender services. Services and practice guidelines are responding to these changes.AimThis systematic review examines the numbers and characteristics...

Predictive algorithms and racial bias: a qualitative descriptive study on the perceptions of algorithm accuracy in higher education

PurposeThis study aims to explore the perception of algorithm accuracy among data professionals in higher education.Design/methodology/approachSocial justice theory guided the qualitative descriptive study and emphasized four principles: access, participation, equity and human rights. Data collection included eight online open-ended questionnaires and six semi-structured interviews. Participants included higher education professionals who have worked with predictive algorithm (PA) recommendations programmed with student data.FindingsParticipants are aware of systemic and racial bias in their PA inputs and outputs and acknowledge their responsibility to ethically use PA recommendations with students in historically underrepresented groups (HUGs). For some participants, examining these topics through the lens of social justice was a new experience, which caused them to look at PAs in new ways.Research limitations/implicationsSmall sample size is a limitation of the study. Implications for practice include increased stakeholder training, creating an ethical data strategy that protects students, incorporating adverse childhood experiences data with algorithm recommendations, and applying a modified critical race theory framework to algorithm outputs.Originality/valueThe study explored the perception of algorithm accuracy among data professionals in higher education. Examining this topic through a social justice lens contributes to limited research in the field. It also presents implications for addressing racial bias when using PAs with students in HUGs.

The Intersection of Neighborhood Environment and Adverse Childhood Experiences: Methods for Creation of a Neighborhood ACEs Index.

This study evaluated methods for creating a neighborhood adverse childhood experiences (ACEs) index, a composite measure that captures the association between neighborhood environment characteristics (e.g., crime, healthcare access) and individual-level ACEs exposure, for a particular population. A neighborhood ACEs index can help understand and address neighborhood-level influences on health among individuals affected by ACEs. Methods entailed cross-sectional secondary analysis connecting individual-level ACEs data from the Philadelphia ACE Survey (n = 1677) with 25 spatial datasets capturing neighborhood characteristics. Four methods were tested for index creation (three methods of principal components analysis, Bayesian index regression). Resulting indexes were compared using Akaike Information Criteria for accuracy in explaining ACEs exposure. Exploratory linear regression analyses were conducted to examine associations between ACEs, the neighborhood ACEs index, and a health outcome—in this case body mass index (BMI). Results demonstrated that Bayesian index regression was the best method for index creation. The neighborhood ACEs index was associated with higher BMI, both independently and after controlling for ACEs exposure. The neighborhood ACEs index attenuated the association between BMI and ACEs. Future research can employ a neighborhood ACEs index to inform upstream, place-based interventions and policies to promote health among individuals affected by ACEs.

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

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

First-time exploration of adverse childhood experiences among adults in Delaware using BRFSS data: A cross-sectional study

ObjectiveIn 2019, for the first time, Delaware collected adverse childhood experiences (ACEs) data through the population-based Behavioral Risk Factor Surveillance System (BRFSS). The main objective of this study was to explore and delineate the prevalence of ACEs and determine their association with select chronic conditions/risk behaviors. Study designA cross-sectional population-based study. MethodsDelaware BRFSS 2019 data (N = 3,879) were analyzed. This includes 2,015 respondents with at least one ACE and 1,882 without ACE. Logistic regression was performed using SAS complex weighting procedures to compare the prevalence odds of selected conditions while controlling for age, gender, and race/ethnicity in Delawareans with and without ACEs. Delaware BRFSS participant response rate was 38.2% comparable to other federal survey responses. ResultsNearly one in four adults reported high ACEs scores (≥3). Emotional abuse was the most common ACE. ACEs were significantly associated with poorer health outcomes. High ACE scores were more prevalent among women, multiracial/minority race groups, bisexual, lesbian/gay sexually oriented, younger age group, and less educated. Associations between high ACEs score and selected health conditions/behaviors remained statistically significant even after controlling for socio-demographic characteristics. ConclusionReporting of ACEs data is critical for Delaware's progress towards a Trauma-Informed State. A particularly disturbing finding was that a high number of young adults reported 3 or more ACEs. Strong association with chronic conditions, particularly mental health was a significant cause for concern. Study results present a first-time expansive coverage, providing stakeholders with a unique opportunity to prioritize evidence-based decisions in Trauma-Informed Delaware.

Cumulative risk, factor analysis, and latent class analysis of childhood adversity data in a nationally representative sample

BackgroundChildhood adversity is a multifaceted construct that is in need of comprehensive operationalisation. ObjectiveThe aim of this study was to explore the optimal method to operationalise a scale of adverse childhood experiences (ACEs). Participants and settingData were from Wave 1 of the Personality and Total Health (PATH) Through Life Project (N = 7485, 51% women). Participants from three age groups (20–25, 40–45, 60–65) retrospectively reported their childhood experiences of domestic adversity on a 17-item scale (e.g., physical abuse, verbal abuse, neglect, poverty). MethodsWe compared three approaches to operationalising the 17-item scale: a cumulative risk approach, factor analysis, and latent class analysis (LCA). The cumulative risk and dimensional models were represented by a unidimensional and two-dimensional model respectively using confirmatory factor analysis (CFA). ResultsThe cumulative risk approach and LCA were viable approaches to operationalising ACE data in PATH. CFA of the dimensional model produced latent factors of threat and deprivation that were highly correlated, potentially leading to problems with multicollinearity when estimating associations. LCA revealed six classes of ACEs: high adversity, low adversity, low affection, authoritarian upbringing, high parental dysfunction, and moderate parental dysfunction. ConclusionOur study found multiple latent classes within a 17-item questionnaire assessing domestic adversity. Using both the cumulative method and latent class approach may be a more informative approach when examining the relationship between ACEs and later health outcomes. Future ACE studies may benefit by considering multi-dimensional approaches to operationalising adversity.

The Unintended Consequence of Novel Coronavirus (COVID-19) Pandemic on Racial Inequities Associated With Adverse Childhood Experiences (ACEs): Findings From a Population-Based Study.

A rising concern is the COVID-19 pandemic effect on adverse childhood experiences (ACEs) due to increased parental stress and social/physical isolation. These pandemic effects are likely to be higher in already marginalized communities. The objective of this ecological study was to examine the relationship between COVID-19 cases and deaths, race/ethnicity, and the estimated number of adults with ACEs using data from South Carolina (SC). COVID-19 reported cases and death data were obtained from the SC Department of Health and Environmental Control. ACE data was used from the 2014–2016 SC Behavioral Risk Factor Surveillance System. Census data were used to obtain county population data. To measure the relationship between these variables, the Spearman rank-order correlation test was used because the data distribution was non-normal. There was a moderate relationship between the estimated number of adults with one or more ACEs and deaths (ρ = 0.89) and race/ethnicity-specific COVID-19 case counts by county (Black: ρ = 0.76; =White: ρ = 0.96; Hispanic: ρ = 0.89). Further, the Spearman correlation test showed the strongest relationship between COVID-19 deaths and race-ethnicity-specific county populations was with the Black adult population (ρ = 0.90). Given the known link between existing health inequities and exposure to COVID-19, these results demonstrate that the current pandemic could have unintended consequences on the well-being of children and caregivers. Response efforts should consider promoting protective factors for children and families and advocating for equitable policies and systems that serve children.

Infant Mental Health Home Visiting Mitigates Impact of Maternal Adverse Childhood Experiences on Toddler Language Competence: A Randomized Controlled Trial.

The goal of this study was to test the impact of maternal adverse childhood experiences (ACEs) on subsequent child language competence; higher parental ACEs were expected to predict risk of toddler language delay. Participation in Infant Mental Health Home Visiting (IMH-HV) treatment, which aims to enhance responsive caregiving and improve child social-emotional development, was expected to mitigate this association. A randomized controlled trial (RCT) design was used. ACEs data were collected at baseline. Child language screening (using the Preschool Language Scales Screening Test) was conducted 12 months later by masters-level evaluators who were blind to treatment condition. Visits occurred in participants' homes. Participants were community-recruited and were randomized to treatment (psychotherapeutic IMH-HV) or control (treatment as usual). Data come from 62 families who participated in all waves of an RCT testing the efficacy of IMH-HV; mothers were eligible based on child age (<24 mo at enrollment) and endorsement of ≥2 sociodemographic eligibility criteria (economic disadvantage, depression, perceived parenting challenges, and/or high ACEs). The age of mothers enrolled in this ranged from 19 to 44 years (M = 31.91; SD = 5.68); child age at baseline ranged from prenatal to 26 months (M = 12.06; SD = 6.62). The maternal ACE score predicted child language competence (t (5,55) = -3.27, p = 0.002). This effect was moderated by treatment (t (6,54) = 1.73, p = 0.04), indicating no association between maternal ACEs and child language for those randomized to IMH-HV. The results highlight that the effects of parent ACEs on early childhood outcomes may be buffered by participation in psychotherapeutic home visiting (trial registration: NCT03175796).

Adverse Childhood Events in American Indian/Alaska Native Populations

Adverse childhood experiences are linked to deleterious outcomes in adulthood. Certain populations have been shown to be more vulnerable to adversity in childhood than others. Despite these findings, research in this area lacks an empirical investigation that examines adverse childhood experiences among American Indian and Alaska Native populations using large, nationally representative data. As such, the authors have compiled what they believe is the largest empirical investigation of adverse childhood experiences among American Indian and Alaska Native individuals to date. Data were collected from the Behavioral Risk Factor Surveillance System from 34 states (2009-2017), whereby all individuals self-report as American Indian and Alaska Native (N=3,894). Adverse childhood experience scores were calculated and further stratified by sex, age, household income, education, employment status, sexual orientation, Census region, and state. In addition, frequencies and prevalence of each adverse childhood experience domain (stratified by the same categories) were calculated. Analysis was conducted in 2019. The average adverse childhood experience score among American Indians and Alaska Natives was 2.32, higher than those of individuals identifying as White (1.53), Black (1.66), and Hispanic (1.63). Female participants had a higher average adverse childhood experience score than male participants (2.52 vs 2.12). Generally, younger individuals and those with lower incomes reported higher adverse childhood experience scores, whereas those with higher educational attainment reported lower scores. Compared with the few studies among American Indian and Alaska Native populations that have used either smaller samples or nontraditional adverse childhood experience data (i.e., asking parents about their children's experiences), these results present overall higher adverse childhood experience averages than previously published studies. Nevertheless, aligning with other research on adverse childhood experiences, female individuals, younger adults, and sexual minorities reported higher adverse childhood experiences scores than other categories in their respective demographics.

Adverse childhood experiences in relation to drug and alcohol use in 30 days prior to incarceration in a county jail

PurposeThe purpose of this paper is to characterize the relationship between adverse childhood experiences (ACEs) and substance use among people incarcerated in a county jail.Design/methodology/approachA questionnaire was administered to 199 individuals incarcerated in a Southwest county jail as part of a social-epidemiological exploration of converging comorbidities in incarcerated populations. Among 96 participants with complete ACEs data, the authors determined associations between individual ACEs items and a summative score with methamphetamine (meth), heroin, other opiates and cocaine use and binge drinking in the 30 days prior to incarceration using logistic regression.FindingsPeople who self-reported use of methamphetamine, heroin, other opiates or cocaine in the 30 days prior to incarceration had higher average ACEs scores. Methamphetamine use was significantly associated with living with anyone who served time in a correctional facility and with someone trying to make them touch sexually. Opiate use was significantly associated with living with anyone who was depressed, mentally ill or suicidal; living with anyone who used illegal street drugs or misused prescription medications; and if an adult touched them sexually. Binge drinking was significantly associated with having lived with someone who was a problem drinker or alcoholic.Social implicationsThe findings point to a need for research to understand differences between methamphetamine use and opiate use in relation to particular adverse experiences during childhood and a need for tailored intervention for people incarcerated in jail.Originality/valueSignificant associations between methamphetamine use and opiate use and specific ACEs suggest important entry points for improving jail and community programming.

Prevalence of Adverse Childhood Experiences of Parenting Women in Drug Treatment for Opioid Use Disorder.

Descriptive adverse childhood experience (ACE) prevalence data on parenting women seeking treatment for opioid use disorder (OUD) is limited, despite this group being one of the fastest growing sub-populations of the opioid epidemic. The aim of this study was to: (1) determine prevalence of ACEs) in a population of parenting women in treatment for OUD, (2) characterize ACEs, and (3) compare study ACE data to Pennsylvania Behavioral Risk Factor Surveillance System (PA BRFSS) to normalize study results. Between 2014 and 2018, ACEs were collected from parenting women (N = 152) enrolled in treatment for OUDs. Results showed on average women were 30.3years of age (SD 4.6, range 22-41years) non-Hispanic (87.0%), white (74.0%), and held a high school education or less (76.0%). The mean total ACE score was 4.3 (SD 2.3; range 0-8). Most women reported 4 ≥ ACEs (65.0%), while only 5.0% reported 0 ACEs. The current sample had higher mean ACE score (4.3 PSMDT vs. 1.4 PA BRFSS Data) than PA BRFSS Data. The burden of ACEs in parenting women in treatment for OUD is significant. Understanding the trauma parenting women in drug treatment have experienced, may support efforts to reduce stigma of this population. Public health intervention and policy work that is trauma proactive is needed to address this growing epidemic.

Association of Timing of Adverse Childhood Experiences and Caregiver Support With Regionally Specific Brain Development in Adolescents

Few data are available to inform the associations and timing of the associations between adversity, caregiver support, and brain outcomes. Consideration of timing has important public health implications to inform more precise prevention strategies. To evaluate the timing and regional specificity of the association between adverse childhood experiences (ACEs) and caregiver support to structural development of limbic and striatal brain regions in middle childhood and adolescence. This 15-year developmental, neuroimaging cohort study included 211 children and their caregivers screened from day care centers and preschools in the St Louis, Missouri, metropolitan area during the preschool period, with an additional 4 waves of neuroimaging at school age through adolescence from November 14, 2007, to August 29, 2017. The cohort was oversampled for preschoolers with elevated symptoms of depression using a brief screener. Data analysis was performed from March 19, 2019, to July 26, 2019. Volumes in adolescence and developmental trajectories of volumes of the amygdala, hippocampus, caudate, subgenual cingulate, and insula during 4 waves of scanning; ACEs and observed caregiver support at preschool and school age; and volumes of amygdala, hippocampus, insula, and subgenual cingulate during 4 waves of scanning. A total of 211 children (107 [50.7%] male) completed at least 1 scan. At preschool (mean [SD] age, 5.5 [0.8] years), ACE data were available for 164 children (84 [51.2%] male) and maternal support data for 155 children; at school age (mean [SD], 8.3 [1.2] years), ACE data were available for 172 children and maternal support data for 146 children. Unique patterns of the association between ACEs and support were found, with an association between the interaction of preschool ACEs and school-age support and the development of the hippocampus (t = -2.27; P = .02) and amygdala (t = -2.12; P = .04). A buffering hypothesis was not confirmed because high caregiver support was more strongly associated with the development of these regions only in the context of low ACEs. In contrast, preschool ACEs (t = -2.30; P = .02) and support (t = 2.59; P = .01) had independent associations with the development of the caudate. The findings suggest that there are unique regional associations of support and adversity with key brain structures important for emotional regulation. Results may inform the timing and potential targets of preventive action for the range of poor developmental outcomes.

Adverse childhood experiences and adult inflammation: Single adversity, cumulative risk and latent class approaches

Abstract Background Adverse childhood experiences (ACEs) have long been known to be related to poorer health across the life course. Previous studies typically relied on cumulative risk scores or individual adversities measured through retrospective self-reports. However, these approaches have important limitations. Cumulative risk scores assume equal weighting of adversities and the single adversity approach ignores the high probability that adversities co-occur. In contrast, latent class analysis (LCA) offers an alternative approach to operationalise ACEs that respects the clustering of adversities and may identify specific patterns of ACEs important for health outcomes. Furthermore, prospective and retrospective reports of ACEs show poor agreement. Therefore, it is important to compare findings based on prospective and retrospective measures in the same individuals. Despite an increasing number of studies applying LCA to ACEs data, no studies have yet simultaneously investigated LCA to cumulative risk and single adversity approaches in their relationships with adult inflammation. Identifying the specific ACEs or combinations of ACEs which are strongly related to inflammation is important for investigating the mechanisms involved and the planning of effective interventions. Methods Using data on 8810 members of the 1958 British birth cohort we investigated 12 ACEs – physical, psychological and sexual abuse, physical and emotional neglect, parental mental health problems, witnessing abuse, parental conflict, parental divorce, parental offending, parental substance misuse and parental death. LCA was applied to explore the clustering of prospectively and retrospectively reported ACEs separately. Associations between latent classes, cumulative risk scores and individual adversities with three inflammatory markers (C-Reactive Protein, fibrinogen and von Willebrand Factor) were tested using linear regression. Results There was co-occurrence between adversities, and particularly for retrospectively reported adversities. Three latent classes were identified in the prospective data – ‘Low ACEs’ (95.7%), ‘Household dysfunction’ (2.8%) and ‘Parental loss’ (1.5%) which were related to increased inflammation in mid-life, as were high ACE scores and individual measures of offending, death, divorce, physical neglect and family conflict. Four latent classes were identified in the retrospective data – ‘Low ACEs’, ‘Parental mental health and substance misuse’, ‘Maltreatment and conflict’ and ‘Polyadversity.’ The latter two (5.2%) were related to raised inflammation in mid-life, as was a retrospective ACE score of 4+ (8.3%) and individual measures of family conflict, psychological and physical abuse, emotional neglect and witnessing abuse. Conclusions Specific ACEs or ACE combinations might be important for chronic inflammation. LCA is an alternative approach to operationalising ACEs data but further research is needed.

Do sleep problems mediate the link between adverse childhood experiences and delinquency in preadolescent children in foster care?

Adverse childhood experiences (ACEs) are associated with multiple mental and physical health problems. Yet, mechanisms by which ACEs confer risk for specific problems are largely unknown. Children in foster care typically have multiple ACEs and high rates of negative sequelae, including delinquent behaviors. Mechanisms explaining this link have not been explored in this population. Impaired sleep has been identified as a potential mechanism by which ACEs lead to delinquency in adolescents, because inadequate sleep may lead to poor executive function and cognitive control - known risk factors for delinquency. Interviews were conducted with 516 maltreated children in foster care, ages 9-11years, and their caregivers regarding child exposure to ACEs, sleep problems, engagement in delinquent acts, symptoms of posttraumatic stress disorder, and current psychotropic medication use. ACEs data were also obtained from child welfare case records. After controlling for age, gender, race/ethnicity, placement type (residential, kin, foster), length of time in placement, posttraumatic stress symptoms, and current psychotropic medication use, sleep partially mediated the association between ACEs and delinquency. Although delinquency is likely multiply determined in this population, improving sleep may be one important strategy to reduce delinquency.

Adverse childhood experiences and frequent insufficient sleep in 5 U.S. States, 2009: a retrospective cohort study

BackgroundAlthough adverse childhood experiences (ACEs) have previously been demonstrated to be adversely associated with a variety of health outcomes in adulthood, their specific association with sleep among adults has not been examined. To better address this issue, this study examines the relationship between eight self-reported ACEs and frequent insufficient sleep among community-dwelling adults residing in 5 U.S. states in 2009.MethodsTo assess whether ACEs were associated with frequent insufficient sleep (respondent did not get sufficient rest or sleep ≥14 days in past 30 days) in adulthood, we analyzed ACE data collected in the 2009 Behavioral Risk Factor Surveillance System, a random-digit-dialed telephone survey in Arkansas, Louisiana, New Mexico, Tennessee, and Washington. ACEs included physical abuse, sexual abuse, verbal abuse, household mental illness, incarcerated household members, household substance abuse, parental separation/divorce, and witnessing domestic violence before age 18. Smoking status and frequent mental distress (FMD) (≥14 days in past 30 days when self-perceived mental health was not good) were assessed as potential mediators in multivariate logistic regression analyses of frequent insufficient sleep by ACEs adjusted for race/ethnicity, gender, education, and body mass index.ResultsOverall, 28.8% of 25,810 respondents reported frequent insufficient sleep, 18.8% were current smokers, 10.8% reported frequent mental distress, 59.5% percent reported ≥1 ACE, and 8.7% reported ≥ 5 ACEs. Each ACE was associated with frequent insufficient sleep in multivariate analyses. Odds of frequent insufficient sleep were 2.5 (95% CI, 2.1-3.1) times higher in persons with ≥5 ACEs compared to those with no ACEs. Most relationships were modestly attenuated by smoking and FMD, but remained significant.ConclusionsChildhood exposures to eight indicators of child maltreatment and household dysfunction were significantly associated with frequent insufficient sleep during adulthood in this population. ACEs could be potential indicators promoting further investigation of sleep insufficiency, along with consideration of FMD and smoking.

Correlation of adverse childhood experiences with psychiatric disorders and aggressiveness in adulthood

Consequences of individual adverse childhood experiences for adult mental health have been precisely studied during past decades. The focus of past research was mainly on childhood maltreatment and neglect. The aim of this paper was to determine association between multiple adverse childhood experiences and psychiatric disorders, as well as their correlation to the degree and type of aggressiveness in adult psychiatric patients. One hundred and thirteen psychiatric outpatients were divided into three diagnostic groups: psychotics, non-psychotics and alcoholics and compared with fourty healthy individuals. Adverse childhood experiences data were gathered retrospectively, using the Adverse childhood experiences questionnaire and explanatory interview. Aggressiveness was assessed using Buss-Perry Aggression Questionnaire. The Student's t test, ANOVA and correlational analysis were used for evaluation of statistical significance of differences among the groups. A value p < 0.05 was considered statistically significant. Our results showed that the mean number of adverse childhood experiences in each group of psychiatric patients, as well as in the whole group of patients, was statistically significantly higher than in the group of healthy individuals (p < 0.001); there was a statistically significant difference in score of physical aggressiveness between the patients exposed to adverse childhood experiences and those who were not exposed to them (p < 0.05); scores of physical aggressiveness were in positive correlation with the number of adverse childhood experiences (p < 0.05). The highest mean score of adverse childhood experiences was evidenced in the group of patients with psychotic disorders. Multiple adverse childhood experiences are significantly associated with psychotic disorders, nonpsychotic disorders and alcohol dependence in adulthood and their presence is important morbidity risk factor for psychiatric disorders. They are in positive correlation with physical aggressiveness of the patients from these diagnostic groups.