Adverse Childhood Experiences Scores Research Articles

Electrocortical Profiles in Relation to Childhood Adversity and Depression Severity: A Preliminary Report.

Objective: Assessment of electroencephalographic (EEG) activity in depression has provided insights into neural profiles of the illness. However, there is limited understanding on how symptom severity and risk factors, such as childhood adversity, influence EEG features. Methods: Eyes-closed EEG was acquired in N = 28 depressed individuals being treated in a tertiary psychiatric setting. Absolute alpha, beta, theta, and delta power and inter-/intra-hemispheric coherence were examined. Relations between the Montgomery-Åsberg Depression Scale (MADRS) and Adverse Childhood Experience (ACE) Questionnaire and EEG features were assessed. Results: Individuals in the high (MADRS≥30) versus lower (MADRS ≤ 29) symptom severity group exhibited greater overall beta power, and lower Fp1-Fp2 delta and theta coherence. Those with high (≥3) versus lower (≤2) ACE scores exhibited greater T7-T8 beta coherence. Lowest F3-F4 beta coherence was observed in those with high ACE/high depression severity. A negative correlation existed between F8-P8 alpha coherence and symptom severity. Conclusions: Those with higher depression severity exhibit increased beta power, possibly reflecting a hyper-vigilant state. Depression severity and ACE history may produce subtle alterations in frontal delta/theta and temporal/frontal beta coherence regions. Significance: This is the first study to examine the neural impact of depression severity and ACE-assessed childhood trauma in depressed individuals receiving treatment in a tertiary setting, accounting for the clinical reality of the prevalence of their co-occurrence.

The Impact of Adverse Childhood Experiences on Asthma Severity in US Adults

Background/objectives: The association between adverse childhood experiences (ACEs) and asthma severity among United States (US) adults with asthma has not been well documented. In addition, whether gender differences exist in this association has been underexplored. We aimed to examine the prevalence of asthma severity in the US adult population with asthma and investigate the association between ACEs and asthma severity by using data from non-institutionalized US adults with asthma. Methods: This cross-sectional study used data from the Adult 2019 and 2020 Behavioral Risk Factor Surveillance System (BRFSS) Asthma Call-Back Survey (ACBS), a survey of US adults aged 18 years or older in 31 US states and Puerto Rico. A total of 22934 adults with asthma participated in 2019 and 2020 ACBS. The 11 BRFSS ACE variables encompassing abuse and household dysfunction were used as ACE measures. ACE measures were summed up as cumulative ACE scores (continuous) and categorized (zero, one ACE, two ACEs, ≥ three ACEs). Asthma severity was categorized as intermittent or persistent. Weighted logistic regression models were used to assess associations of the cumulative ACE score, categorical ACE measures, and the 11 individual ACE responses with asthma severity controlling confounders. Gender differences were explored by stratifying by gender. Results: The prevalence of persistent asthma among US adults with asthma was 45.3%. The mean cumulative ACE score in adults with intermittent vs. persistent asthma was (2.43 vs. 2.70, p-value < 0.05). About 22% of adults with asthma had no ACEs, 19% had one ACE, 14% had two ACEs, and 45% had three or more ACEs. A one-unit increase in ACEs score was associated with a 5.4% increase in the odds of persistent asthma (adjusted odds ratio, aOR = 1.054 (95% confidence interval, CI = 1.01–1.10). Experiencing ≥ three ACEs compared to no ACEs was associated with 31% increased odds of persistent asthma (aOR = 1.31, 95% CI = 1.01–1.70). Individual ACE items significantly associated with persistent asthma include parent/adult ever touched you sexually (aOR = 1.33, 95% CI = 1.03–1.74), adult tried to make you touch them (aOR = 1.34, 95% CI = 1.01–1.79), any adult forced you to have sex (aOR = 1.44, 95% CI = 1.04–1.20), parental separation/divorce (aOR = 1.31, 95% CI = 1.05–1.63), and household alcohol abuse (aOR = 1.24, 95% CI = 1.01–1.53). In women, experiencing one ACE and ≥ three ACEs (compared to no ACEs) was associated with 51% and 60% increased odds of persistent asthma, respectively (aOR = 1.51, 95% CI = 1.02–2.23; aOR = 1.60, 95% CI = 1.12–2.27). No significant association was observed between ACEs and asthma severity in men; however, experiencing household physical violence (compared to no household physical violence) was associated with persistent asthma in men (aOR = 1.69, 95% CI = 1.18–2.42). Conclusions: In this cross-sectional study of US adults with asthma, exposure to ACEs was associated with higher odds of asthma overall and in women. These findings highlight the importance of preventive strategies and early interventions to reduce ACEs, potentially mitigating asthma’s severity in adulthood.

Preliminary Evidence for Neuronal Dysfunction Following Adverse Childhood Experiences: An Investigation of Salivary MicroRNA Within a High-Risk Youth Sample

Background/Objectives: Adverse childhood experiences (ACEs) are potent drivers of psychopathology and neurological disorders, especially within minoritized populations. Nonetheless, we lack a coherent understanding of the neuronal mechanisms through which ACEs impact gene expression and, thereby, the development of psychopathology. Methods: This observational pilot study used a novel marker of neuronal functioning (brain-derived micro ribonucleic acids, or miRNAs) collected via saliva to explore the connection between ACEs and neuronal gene expression in 45 adolescents with a collectively high ACE exposure (26 males and 19 females of diverse races/ethnicities, with six cumulative ACEs on average). We aimed to determine the feasibility of using salivary microRNA for probing neuronal gene expression with the goal of identifying cellular processes and genetic pathways perturbed by childhood adversity. Results: A total of 274 miRNAs exhibited reliable salivary expression (raw counts > 10 in > 10% of samples). Fourteen (5.1%) were associated with cumulative ACE exposure (p < 0.05; r’s ≥ 0.31). ACE exposure correlated negatively with miR-92b-3p, 145a-5p, 31-5p, and 3065-5p, and positively with miR-15b-5p, 30b-5p, 30c-5p, 30e-3p, 199a-3p, 223-3p, 338-3p, 338-5p, 542-3p, and 582-5p. Most relations remained significant after controlling for multiple comparisons and potential retrospective bias in ACE reporting for miRNAs with particularly strong relations (p < 0.03). We examined KEGG pathways targeted by miRNAs associated with total ACE scores. Results indicated putative miRNA targets over-represented 47 KEGG pathways (adjusted p < 0.05) involved in neuronal signaling, brain development, and neuroinflammation. Conclusions: Although preliminary and with a small sample, the findings represent a novel contribution to the understanding of how childhood adversity impacts neuronal gene expression via miRNA signaling.

Traumatic and Adverse Childhood Experiences and Developmental Differences in Psychiatric Risk

While adverse childhood experiences (ACEs) are known to impart significant risk for negative mental health and cognitive outcomes in youth, translation of ACE scores into clinical intervention is limited by poor specificity in predicting negative outcomes. This work expands on the ACE framework using a data-driven approach to identify 8 different forms of traumatic and adverse childhood experiences (TRACEs) and reveal their differential associations with psychiatric risk and cognition across development. Building upon the traditional ACEs model, this study aimed to characterize unique components of commonly co-occurring TRACEs and to examine moderation of longitudinal change in mental health and cognitive development during adolescence. This work draws from youth and their caregivers who completed up to 4 annual behavioral assessments from 2016 to 2021 as part of the ongoing Adolescent Brain Cognitive Development (ABCD) study. Data collection was performed at 21 regionally-distributed sites across the United States. Analyses for this work were conducted January 2023 through November 2023. Youth participants in the ABCD study's exposure to 268 different TRACEs, which were distilled into adversity components using nonlinear principal components analysis. Mixed-effects and latent change score models considered TRACEs components as moderators of longitudinal change in internalizing and externalizing mental health problems, as well as longitudinal change in cognitive ability. Data were distilled from 11 876 youth participants, who were grouped into dyads with a caregiver. ABCD study youth participants were 9 to 10 years old at baseline assessment (year 0) and 12 to 13 years old at ABCD year 3. A total of 5679 participants (47.8%) were female. Analyses revealed that TRACEs organized into 8 thematic adversity components (e.g., family conflict, interpersonal violence). At baseline assessment (year 0), exposure to nearly every adversity component was associated with poorer mental health and diminished cognitive ability. Yet across time, it was observed that different forms of adversity were variably linked to both increases and decreases in internalizing and externalizing problems. For example, while peer aggression (t = 5.31) and family conflict (t = 5.67) were associated with increases in both internalizing and externalizing problems over early adolescence, community threat (t = 2.82) and poverty (t = 2.07) were linked to decreased problems, potentially representing adaptive suppression of symptoms. Finally, adversity types related to resource deprivation (eg, poverty, caregiver maladjustment) were associated with declines in cognitive ability over early adolescence. In this cohort study, distinct forms of TRACEs differentially moderated developmental changes in psychiatric risk and cognitive ability in different ways, offering the possibility for precision-based prediction of risk for youth. Such findings could be used in targeted early prevention and intervention strategies for at-risk youth.

Challenging the use of the overall adverse childhood experiences (ACEs) score: Comparing total ACEs, maltreatment, and household dysfunction on mental health problems among White, African American, and Native American women under correctional control.

Adverse childhood experiences (ACEs) have been consistently linked to mental health problems. There have been recent conceptual and empirical critiques that suggest maltreatment and household dysfunction to not be combined to create a composite ACE score. Women in correctional custody demonstrate disproportionately high ACE levels and greater mental health problems as to racial minorities. The present study compared the effects of varying operationalizations of the ACEs measure on women's mental health stratified across race using a sample of White, African American, and Native American women in correctional custody in Oklahoma. The cross-sectional study administered a paper-and-pencil survey to 494 women. Structural equation modeling was used to test hypotheses. Maltreatment was a significant predictor of women's mental health across all racial groups but demonstrated the strongest effect among African American inmates. Household dysfunction was not a significant predictor of mental health for any racial group. When comparing the maltreatment-only model to the maltreatment and household dysfunction model, and the overall ACE score model, there was little explained variance lost. These findings indicate that maltreatment demonstrates unique associations with women's mental health and may be the driving force behind the relationship between ACEs and adult mental health among women within correctional custody. Researchers are advised to not use the overall ACE score and instead break down the measure into the maltreatment and household dysfunction subscales. (PsycInfo Database Record (c) 2024 APA, all rights reserved).

Feasibility Study of Adverse Childhood Experiences, Treatment-Related Sequelae, and Inflammatory Markers in Breast Cancer Survivors.

To explore the incidence of adverse childhood experiences (ACEs) in breast cancer survivors and potential associations with long-term treatment-related sequelae. English-speaking breast cancer survivors three or more years from diagnosis with complete treatment response (N = 120) were recruited prior to scheduled survivorship clinic visits. Participants in this cross-sectional observational feasibility study rated anxiety, depression, fatigue, sleep disturbance, cognitive issues, resilience, and ACEs (experienced prior to age 18 years). Blood samples were analyzed for inflammatory and epigenetic biomarkers. ACEs assessment was feasible. Higher ACE scores correlated with greater fatigue, anxiety, and depression, and with lower cognitive function (p < 0.05). Resilience was positively associated with cognitive function and negatively associated with fatigue, anxiety, and depression. There is evidence for the impact of ACEs on long-term treatment-related sequelae in women with breast cancer. Oncology nurses should consider incorporating ACEs assessment into the workflow for women receiving survivorship care.

Association between adverse childhood experiences and pregnancy morbidities: A nationwide online-based cross-sectional study.

To examine the association between adverse childhood experiences (ACEs) and pregnancy morbidities, including preterm birth (PTB), gestational diabetes (GDM), preeclampsia, and small-for-gestational-age (SGA) among the general population in Japan. The data were from the JACSIS study, an online-based nationwide survey conducted from July to August 2021 in Japan (N = 5444). ACEs included physical, sexual, and psychological abuse, neglect, childhood poverty, bully victimization, domestic violence, parental death, and parental divorce. Pregnancy morbidities, including PTB, GDM, preeclampsia, and SGA were identified through questionnaires. A multivariable logistic regression model was applied. Of 5444 women, 2778 (51.0%) had no ACEs, and 374 (6.9%) had four or more ACEs. A dose-response association was found between total ACE score and PTB and preeclampsia (p-value: 0.016 and 0.001). Women with four or more ACE scores showed higher risks of preeclampsia (adjusted odds ratio [aOR] [95% confidence interval, CI]: 3.06 [1.57-5.94], p-value: 0.001). Besides, those with two or three ACEs had higher risks of PTB (aOR [95%CI]: 1.42 [1.01-2.02], p-value: 0.046, and aOR [95%CI]: 1.61 [1.04-2.50], p-value: 0.041), and women with one ACE showed a higher risk of GDM (aOR [95%CI]: 1.34 [1.02-1.77], p-value: 0.035). SGA was not associated with ACEs. ACEs were associated with an increased risk of PTB, preeclampsia, and GDM, but not SGA among the general population in Japan.

Adverse Childhood Experiences and Intimate Partner Violence: Exploring Implications for Young Adults' Romantic Outlook.

In the present study, we used data from a community sample of 442 American young adults ages 18 to 35 to explore the associations between adverse childhood experiences (ACEs), intimate partner violence (IPV), and young adults' romantic outlook (i.e., general attitude toward romantic involvement), which includes perceived average relationship quality, desire for relationships, and dismissal of relationships. Guided by a life course perspective, we examined whether ACEs and IPV work together to predict romantic outlook among young adults. We also explored whether education level moderated the effects of ACEs and IPV on romantic outlook during young adulthood. Our findings suggest that different types of IPV (physical, sexual, and psychological) are associated with different outcomes in terms of perceived relationship quality, desire, and dismissal. We also identified several significant findings related to educational attainment. Specifically, in the higher educational attainment group, participants with high ACE scores combined with high rates of IPV reported lower relationship desire and lower perceived relationship quality. These findings suggest a nuanced view of how both childhood experiences and different types of IPV are related to romantic outlook for young adults. Additionally, these findings suggest that higher education levels can strengthen the influence of adverse experiences during one's lifetime (ACEs and/or IPV) on young adults' romantic outlook.

Relevance of ACE Scores in Teens with Depression and Anxiety: A Maui Pilot Study.

In the aftermath of the Covid pandemic and the notable rise of teen depression and anxiety (DA), there is an urgent need to focus on youth mental health. Another important variable to consider is the presence of adverse childhood experiences (ACE), which can be associated with chronic mental and physical health conditions. This pilot study explores how ACEs relate to DA for adolescents in Maui, Hawai'i. The cohort was 75 patients seen at a Kaiser Pediatric Clinic in the spring of 2022. Data was collected from standard questionnaires and the Pediatric ACEs and Life-Events Screener (PEARLS). There were significant associations between DA and a high ACE score (4+), as well as female sex. A high ACE score can alert providers to initiate a trauma informed dialogue with patients. The effects of trauma are not often discussed at routine visits. Mental health care needs and community support can also be addressed as needed. The PEARLS questionnaire is a standard tool to help clinicians be more trauma-informed. This study explores its relevance at routine adolescent visits.

Predicting Mental Health Hospitalizations Among First Nations Adults in Residential Treatment

Indigenous peoples in Canada experience disproportionately higher rates of hospitalization for mental health and substance use concerns than non-Indigenous populations. Ambulatory care sensitive conditions are community-level markers of mental illness which can theoretically be managed through community-based health services, and therefore should not require urgent care services. Previous mental health related ambulatory sensitive conditions have included psychotic and mood disorders; however, limited research has explored these relationships of increased hospitalization among specific health disorders with Indigenous populations. This study analyzed predictors of prior mental health hospitalizations among a predominately First Nations population seeking residential treatment for substance use. We hypothesized that increased co-morbid mental health concerns would predict increased hospitalizations for mental health concerns, and this relationship would be moderated by higher Adverse Childhood Experience (ACE) scores. Logistic regression showed that for every increase in each reported mental health concern, the odds of prior hospitalization was 1.6 times higher among this sample, although ACEs did not moderate this relationship. Participants with depressive, anxiety-related, psychotic, and personality-related disorders reported proportionally more hospitalization. Although study results suggest ACEs are not a useful predictor of hospitalization, their presence has previously shown to exacerbate co-morbid concerns, and thus, may influence prior hospitalization history indirectly. Further research can explore relationships between exposure to childhood trauma and hospitalization, particularly in consideration of access to tertiary mental health services.

Exploring the impact of adverse childhood experiences on health and cognitive functions in older adults.

This study examines whether adverse childhood experiences (ACEs) predict long-term health issues and how ACEs, alongside stress, impact well-being and cognitive abilities in older adults. 279 adults were categorized into three age groups (30-46, 47-60, and 61-80). Participants completed an online survey assessing health problems, stress, resilience, and ACEs. Additionally, 32 older adults underwent cognitive tests. ACE scores predicted physical and psychological diseases in adults but not in older adults. However, a significant correlation between ACEs and cognitive abilities was evident in older participants. ACEs are significant indicators of long-term health issues and stress in adults but may not predict these factors in older individuals. Understanding ACEs' impact on cognitive abilities in older adults is crucial for tailored interventions and support.

"I Just Wouldn't Like Him to go Through What I Went Through as a Kid": A Qualitative Study on the Mitigating Effects of Positive Childhood Experiences in Mothers with a History of Adverse Childhood Experiences in an Irish Population.

Adverse Childhood Experiences (ACEs) are increasingly being acknowledged as a major risk factor for instigating and sustaining cycles of trauma between mother and child. Recently, the concept of Benevolent Childhood Experiences (BCEs) has been introduced to ACEs research as a buffer against the transmission of ACEs between generations. Positive childhood experiences such as attachment to caregivers, positive peer relations and positive sense of self have been found to counteract the effects of adverse childhood experiences. The emergence of positive childhood experiences as an adaptive capacity against ACEs should be explored as a tool for psychological change, to help break the cycle of inherited trauma between generations. The present study aims to examine the lived experiences of mothers with a history of ACEs, if they consider their positive childhood experiences when parenting, and how they use these positive experiences to break the cycle of intergenerational trauma. Three women residing in a low-support service for parenting were recruited for this study. Participants were all low-income, first-time single mothers in their early thirties. A qualitative approach was designed for the study. ACEs and BCEs questionnaires were administered to participants and scores were taken into account to contextualise participant interviews. A semi-structured interview was designed in accordance with IPA guidelines. Questions were directed towards phenomenological material, focusing on participants' understanding of their experiences as mothers. Analysis of the interview data revealed three superordinate themes (replicating positive experiences, creating new positive experiences and protecting children from intergenerational trauma) related to participants' BCEs, their children's BCEs and their desire to break the cycle of intergenerational trauma. The findings of this study, namely that participants intentionally tried to create positive experiences with their own children through drawing on their own positive experiences in childhood, supports the idea that BCEs are a legitimate source of adaptive capacity for mothers with ACEs. Parenting interventions for parents with ACEs should be developed taking into account ACE and BCE scores.

A - 56 Cumulative Childhood Adversity Is Linked with Reduced Cognitive Performance during Late Childhood to Adolescence

Abstract Objective History of adverse childhood experiences (ACEs) has been linked with poorer cognitive performance in young adulthood and cognitive decline in older adults; however, few studies have examined these relationships during childhood and adolescence, which are key periods for neurocognitive development. The current study investigated the longitudinal relationships between ACEs and cognitive performance during late childhood/adolescence. Method 10,827 participants (ages = 9–15.5 years old; 48% female) were included from the Adolescent Brain Cognitive Development Study. Cumulative ACE scores were created using annual parent and child reports of youth’s exposure to ACEs from baseline (ages 9–10) to Year 4 follow-up (ages 13–15). Cognitive performance was assessed using the NIH Toolbox (completed at baseline, Year 2, and Year 4). Separate linear mixed-effects models examined associations between ACEs and cognitive performance while accounting for time, age, sex assigned at birth, caregiver education, household income, pubertal status, internalizing and externalizing symptoms, and random effects of subject and family/twin status. Additional analyses tested for interactions with time. Results Greater ACEs were associated with poorer cognitive performance on tasks measuring verbal (p’s &amp;lt; 0.001) and visual (p &amp;lt; 0.001) memory, working memory (p = 0.01), cognitive flexibility (p = 0.004), processing speed (p &amp;lt; 0.001), and language (p’s &amp;lt; 0.001), above and beyond covariates. ACEs were not associated with attention (p = 0.09). Cognitive performance improved over time; however, compared to baseline, youth with greater ACE history at Year 4 demonstrated poorer attentional performance (p = 0.008). Conclusions Findings suggest that ACEs influence cognitive performance during key neurodevelopmental periods, and future work should assess clinical utility of targeted cognitive remediation in youth with adversity history.

A - 35 Effects of Childhood Trauma Exposure on Psychological Symptom Endorsement among Adult ADHD Referrals

Abstract Objective Adults with attention-deficit/hyperactivity disorder (ADHD) are more likely to have childhood trauma exposure. Trauma exposure evaluations are not always standard practice for adult ADHD evaluations, but personality inventories like the Minnesota Multiphasic Personality Inventory-2-Restructured Form (MMPI-2-RF) are more commonly used to differentiate neurodevelopmental symptoms from psychiatric disorders. This study assessed the impact of childhood trauma exposure on MMPI-2-RF profiles among adults referred for ADHD evaluation. Method Cross-sectional data from 222 patients referred for neuropsychological evaluation for attention concerns and administered the Adverse Childhood Experiences (ACE) Checklist and MMPI-2RF were examined. Patients were racially diverse with a Mage 29.15 (SD = 7.63) and Meducation 16.15 years (SD = 2.13). Patients were divided into low (0–3 ACEs) and high (&amp;gt;3 ACEs) ACE groups. ACEs groups’ MMPI-2RF Restructured Clinical (RC) scale scores were compared via multivariate analyses of variance (MANOVAs) for the overall sample and subsample of those who ultimately received an ADHD diagnosis. Results The sample had 52% low ACEs/48% high ACEs, and 65% ADHD diagnosis/35% non-ADHD diagnosis. Overall, there was a significant multivariate effect (Wilks Λ =0.812; F(9,212) = 5.45, p &amp;lt; 0.001; np2 = 0.188); those with high ACE scores had significantly higher RC1, RC4, RC6, RC7, and RC8 scores. Significant MANOVA effects remained when the sample with subdivided. Across ADHD and non-ADHD subgroups, significantly higher RC4 and RC6 scores were consistent. Conclusions Exposure to childhood trauma had a significant impact on the MMPI-2-RF profile of adults being evaluated for ADHD. Screening for trauma exposure should be incorporated into standard neuropsychological batteries to inform the interpretation of personality inventories used to differentiate psychopathology.

Associations of threat and deprivation-related childhood exposures with children’s mental health and flourishing: The moderating role of family resilience

IntroductionThe association of adverse childhood experience (ACE) with physical and mental well-being is predominantly examined using a cumulative ACE score. However, less is known how different dimensions of adversity (e.g., threat and deprivation) may uniquely predict children’s mental health and development. We examined (i) whether two aspects of ACE – threat and deprivation – are differently associated with children’s anxiety, depression, and flourishing and (ii) whether family resilience and connection index (FRCI) moderates these associations. MethodsWe analyzed data from the National Survey of Children’s Health (2017–20). The analytic sample consisted of 81,626 children (6–17 years). Logistic regression with survey weights was used to obtain odds ratios (OR) and 95 % confidence intervals (CI) adjusting for sociodemographic factors. ResultsThe experience of threat-only ACE and deprivation-only ACE showed differential associations with anxiety, depression, and child flourishing. For example, children who experienced threat-only ACE had a 4.2-fold higher odds of depression (OR=4.2; 95 % CI: 3.37–5.24), and those who experienced deprivation-only ACE had a 2.4-fold (OR=2.4; 95 % CI: 1.98–2.92) higher odds of depression compared to those exposed to neither threat nor deprivation experience. Experiencing both a threat and deprivation showed larger than an additive association with all outcomes. Further, interaction models suggest that the associations of threat and deprivation-type ACE with all outcomes significantly differed by the levels of FRCI. ConclusionsThreat and deprivation dimensions of adversity were differentially associated with mental health and flourishing outcomes in childhood. Family resilience appears to be protective against the negative effect of threat and deprivation dimensions of ACE on children’s mental health and developmental outcomes.

Lifetime Revictimization: Evidence From the Wisconsin Longitudinal Study.

Despite the documented increasing prevalence of elder abuse victimization and its devastating health effects, a life-course view of the victimization experiences of older adults has rarely been adopted in the elder abuse literature. The current study investigated lifetime links between victimization experiences by examining the indirect effect of adverse childhood experiences (ACE) on elder abuse victimization via intimate partner violence (IPV) victimization in middle adulthood, and whether this indirect association would differ by gender. Using data from the Wisconsin Longitudinal Study, we analyzed the previous and current victimization experiences of a total of 5,391 older adults in their early 70s and estimated mediational and moderated mediation models. The key results indicated that a higher ACE score was associated with exposure to IPV victimization in middle adulthood, which was in turn associated with exposure to elder abuse victimization. This indirect association was stronger for women than for men. Regarding specific types of childhood victimization, parental physical abuse, sexual abuse, and witnessing domestic violence significantly predicted elder abuse victimization via IPV victimization. Our results support the phenomenon of lifetime victimization, whereby an individual experiences reoccurring forms of victimization across the life course from childhood to late adulthood. Findings highlight the compelling need for the assessment of cumulative victimization experiences and their impact on elder abuse victims. A life-course-based, trauma-informed approach would greatly enhance prevention and intervention services for elder abuse.

Adverse Childhood Experiences and Cognitive Change in Late-Life Depression

ObjectivesTo determine the relationship of adverse childhood experiences (ACEs) with change in cognitive performance over a 1-year period among older adults in treatment for depression. MethodsOlder depressed adults completed the ACEs questionnaire and the Consortium to Establish a Registry of Alzheimer's disease (CERAD) cognitive battery at baseline and were re-assessed with the CERAD 1 year later. ResultsChildhood physical abuse, sexual abuse, and verbal/emotional abuse, respectively, were reported by 25%, 17.5%, and 42% of participants. Total ACEs score was not associated with baseline cognitive performance or 1-year change. However, sexual abuse, physical abuse, and a measure of cumulative verbal/emotional, physical, and sexual abuse were inversely associated with 1-year change in total CERAD score. ConclusionsChildhood abuse may have long-term adverse effects, including placing depressed older adults at risk for progressive cognitive decline. ACEs should be considered in research and clinical management of depression in older adults.

Analyzing the relationship between individual and cumulative score of adverse childhood experiences (ACEs) with self-reported mental health disorders in Chile

BackgroundAdverse Childhood Experiences (ACEs) are widely recognized as significant predictors of poor mental health in adulthood. Latin America presents several unique challenges regarding ACEs, such as higher prevalence of violence and income and political inequality. However, little is known about this issue from nationally representative samples in the region, particularly in Chile. ObjectiveThis investigation examines the association between individual and cumulative ACE scores and seven self-reported mental health conditions (substance abuse, depression, PTSD, generalized anxiety, suicide ideation, non-suicidal self-harm, and learning disorders) in a representative Chilean urban sample. MethodsA representative urban sample of 2101 adult Chileans completed the International Adverse Childhood Experiences Questionnaire (ACE-IQ) and disclosed any prior mental health diagnoses. ResultsAround 40 % of the sample had experienced four or more ACEs in their lifetime. For these individuals, the risk of reporting a mental health disorder was significantly higher. Several logistic regression analyses were conducted to address the associations between ACEs and the seven mental health conditions. Notably, sexual abuse, bullying, and exposure to collective violence were the ACEs most strongly associated with self-reported mental health issues. Additionally, a cumulative ACE score was found to be a significant predictor of having a previous mental health diagnosis. ConclusionsWe found a significant predictive association between exposure to collective violence and six out of the seven self-reported mental health disorders. Similarly, sexual abuse demonstrated an association with all mental health conditions. Finally, individuals who experienced four or more ACEs had a notably higher chance of reporting a previous mental health diagnosis. We recommend conducting further ACE research in Latin America due to its cultural and contextual singularities.

Childhood socio-economic disadvantages versus adverse care experiences: Mediation and moderation impacts on late-life depressive symptoms.

Whether material deprivation-related childhood socio-economic disadvantages (CSD) and care-related adverse childhood experiences (ACE) have different impacts on depressive symptoms in middle-aged and older people is unclear. In the Guangzhou Biobank Cohort Study, CSD and ACE were assessed by 7 and 5 culturally sensitive questions, respectively, on 8,716 participants aged 50+. Depressive symptoms were measured by 15-item Geriatric Depression Scale (GDS). Multivariable linear regression, stratification analyses, and mediation analyses were done. Higher CSD and ACE scores were associated with higher GDS score in dose-response manner (P for trend <0.001). Participants with one point increment in CSD and ACE had higher GDS score by 0.11 (95% confidence interval [CI], 0.09-0.14) and 0.41 (95% CI, 0.35-0.47), respectively. The association of CSD with GDS score was significant in women only (P for sex interaction <0.001; women: β (95% CI)=0.14 (0.11-0.17), men: 0.04 (-0.01 to 0.08)). The association between ACE and GDS score was stronger in participants with high social deprivation index (SDI) (P for interaction = 0.01; low SDI: β (95% CI)=0.36 (0.29-0.43), high SDI: 0.64 (0.48-0.80)). The proportion of association of CSD and ACE scores with GDS score mediated via education was 20.11% and 2.28%. CSD and ACE were associated with late-life depressive symptoms with dose-response patterns, especially in women and those with low adulthood socio-economic status. Education was a major mediator for CSD but not ACE. Eliminating ACE should be a top priority.

The Association Between ACE Score and Having Pre-Pregnancy Health Conversations with a Healthcare Provider (2016-2020).

Adverse Childhood Experiences (ACEs) increase health risks leading to negative pregnancy outcomes, thus prompting the need for preconception care to address these risks. The aim of this study is to assess the association between ACEs score and self-report of having pre-pregnancy health conversations with a healthcare provider. Secondary analysis of PRAMS data from 2016 to 2020 was performed from 3 states and Washington, DC. ACEs score was categorized as 0 (low risk), 1-3 (intermediate risk), and ≥ 4 (high risk). Pre-pregnancy health conversations were measured using reports of being asked about the desire to have children, use birth control to prevent pregnancy, and/or improve health during any visit in the 12months prior to pregnancy. Multivariate Poisson Regression was performed to adjust for potential confounders: age, race/ethnicity, income, education, insurance type, marital status, pregnancy intention, and parity. A total of 10,448 PRAMS survey responses from 2016 to 2020 were included in the analysis. More than half of women reported having at least 1 ACE (51%). Those with an ACE score of ≥ 4 had 1.19 (95% CI: 1.01-1.41) times higher adjusted Prevalence Ratio (aPR) and those with an ACE score of 1-3 had about the same aPR 1.00 (95% CI: 0.93-1.09) of reporting pre-pregnancy health conversations with a healthcare provider compared to those with no ACEs. CONCLUSIONSFOR PRACTICE: The overall low percentage of respondents reporting receipt of pre-pregnancy health conversations with a health care provider indicates the need for these conversations to be had on a more routine basis.