Adverse Childhood Experiences Research Articles

Sex-Specific Association Between Childhood Adversity and Accelerated Biological Aging.

Is childhood adversity associated with biological aging, and if so, does sex modify the association, and do lifestyle and mental health mediate the association? A lifespan analysis is conducted using data on 142872 participants from the UK Biobank to address these questions. Childhood adversity is assessed through the online mental health questionnaire (2016), including physical neglect, physical abuse, emotional neglect, emotional abuse, sexual abuse, and a cumulative score. Biological aging is indicated by telomere length (TL) measured from leukocyte DNA using qPCR, and the shorter TL indicates accelerated biological aging; a lifestyle score is constructed using body mass index, physical activity, drinking, smoking, and diet; mental disorder is assessed using depression, anxiety, and insomnia at the baseline survey. The results reveal a sex-specific association such that childhood adversity is associated with shorter TL in women after adjusting for covariates including polygenic risk score for TL, but not in men. Unhealthy lifestyle and mental disorder partially mediate the association in women. The proportions of indirect effects are largest for sexual and physical abuse. These findings highlight the importance of behavioral and psychological interventions in promoting healthy aging among women who experienced childhood adversity, particularly sexual and physical abuse.

Association between adverse childhood experiences and health related quality of life in adult cancer survivors in the United States.

The impact of adverse childhood experiences (ACEs) on health-related quality of life (HRQOL) is increasingly recognized, however, this has not been studied in cancer survivors in the United States. This study investigates if ACEs are associated with HRQOL in cancer survivors. We conducted a cross-sectional analysis of the 2020 Behavioral Risk Factor Surveillance System from states that administered ACEs and Cancer Survivorship modules. Eligibility criteria included being a cancer survivor and not currently receiving cancer treatment. Primary exposure was number of ACEs (categorized as 0, 1-2, 3, or ≥ 4). Primary outcomes were self-reported measures of HRQOL including worse overall health and ≥ 14 unhealthy days (mentally or physically) per month. Mantel-Haenszel stratified analyses were performed and prevalence ratios were adjusted for age. Of 5,780 participants, 62.0% were female and 67.8% were ≥ 65 years. Prevalence of worse overall health was 22.5% for individuals with no ACEs compared to 30.2% for 2-3 ACEs (aPR = 1.4, 95% CI 1.2, 1.5) and 38.5% for ≥ 4 ACEs (aPR = 1.7, 95% CI 1.5, 2.0). Prevalence of ≥ 14 unhealthy days was 18.1% with no ACEs compared to 21.0% for 1 ACE (aPR = 1.3, 95% CI 1, 1.3), 29.0% for 2-3 ACEs (aPR = 1.6, 95% CI 1.4, 1.8), and 44.8% for ≥ 4 ACEs (aPR = 2.2, 95% CI 2.0, 2.5). Our study provides novel evidence of the association of multiple ACEs with higher prevalence of poor HRQOL in cancer survivors. Screening for ACEs is warranted in all patients to guide targeted interventions to improve HRQOL and mitigate the impact of ACEs on HRQoL in cancer survivors.

Trauma-sensitive school concepts for students with a refugee background: a review of international studies

Children and adolescents with a refugee background are at high risk for traumatization. Once they arrive in safe countries, schools are the institutions where teachers are responsible for caring for them sensitively and competently. Furthermore, schools are organized in learning groups consisting of multiple peers of the same age, which provides excellent opportunities for social learning and experiences of social support. In this respect, schools are the appropriate places where preventive concepts can be applied to students with a refugee background. This systematic review summarizes studies that examine or evaluate existing international concepts of trauma-sensitive schools for supporting traumatized students with a refugee background. Based on N = 41 selected articles, 17 relevant concepts of trauma-sensitive schools were identified. In 35.3% of the concepts, traumatized students with a refugee background are explicitly included in the target group of the concept, while 47.1% of the concepts refer to groups of students with trauma as a result of various adverse childhood experiences, which also occur more frequently within the population of refugee children and adolescents 17.6% of the concepts contain specific adaptations for pupils with a refugee background. The majority of these concepts were developed in the United States. Additional concepts can be reported for Australia, the United Kingdom, Turkey, and Cambodia. Based on available empirical data, no significant effectiveness regarding the researched concepts’ effects on academic and other school-related data can be determined. Although some studies indicate positive effects concerning school-related target variables, most of the studies have only limited significance due to inadequate research designs and methodological deficiencies. Therefore, there is a great need for further development, careful implementation, and evaluation of trauma-sensitive concepts in schools, especially for the growing group of refugee students.

Prevalence of Positive Childhood Experiences Among Adults - Behavioral Risk Factor Surveillance System, Four States, 2015-2021.

Positive childhood experiences (PCEs) promote optimal health and mitigate the effects of adverse childhood experiences, but PCE prevalence in the United States is not well-known. Using Behavioral Risk Factor Surveillance System data, this study describes the prevalence of individual and cumulative PCEs among adults residing in four states: Kansas (2020), Montana (2019), South Carolina (2020), and Wisconsin (2015). Cumulative PCE scores were calculated by summing affirmative responses to seven questions. Subscores were created for family-related (three questions) and community-related (four questions) PCEs. The prevalence of individual PCEs varied from 59.5% (enjoyed participating in community traditions) to 90.5% (adult in respondents' household made them feel safe), and differed significantly by race and ethnicity, age, and sexual orientation. Fewer non-Hispanic Black or African American (49.2%), non-Hispanic Alaska Native or American Indian (37.7%), and Hispanic or Latino respondents (38.9%) reported 6-7 PCEs than did non-Hispanic White respondents (55.2%). Gay or lesbian, and bisexual respondents were less likely than were straight respondents to report 6-7 PCEs (38.1% and 27.4% versus 54.7%, respectively). A PCE score of 6-7 was more frequent among persons with higher income and education. Improved understanding of the relationship of PCEs to adult health and well-being and variation among population subgroups might help reduce health inequities.

Understanding the Impact of Adverse Childhood Experiences on Non-suicidal Self-Injury in Youth: A Systematic Review

Understanding the Impact of Adverse Childhood Experiences on Non-suicidal Self-Injury in Youth: A Systematic Review

Generational differences in latent classes of exposure to adverse childhood experiences

Adverse Childhood Experiences (ACEs) have increased across generations; however, it is unclear how ACE exposure clusters into classes and how exposure differs by generation. To examine this clustering, we used data from the 2019 Behavioral Risk Factor Surveillance Survey (n = 56,262). We identified ACEs exposure classes and examined the probability of belonging to each ACEs exposure class by birth generation, sex assigned at birth, race/ethnicity, and LGBTQ+ identity. We identified three ACEs exposure classes: Low ACEs, High ACEs without Sexual Abuse, and High ACEs with Sexual Abuse. Findings demonstrate that, relative to Baby Boomers, the probability of experiencing High ACEs without Sexual Abuse was 5 % higher for Gen X and 11 % for both Millennials and Gen Z. The probability of experiencing High ACEs with Sexual Abuse was highest for Gen X and lowest for Gen Z. Significant intersectional relationships were found between LGBTQ+ identity and both generation and sex assigned at birth. These findings have implications for health policy.

Stressful life events and the occurrence of skin cancer.

It is widely acknowledged that emotional states can influence skin conditions, yet limited research has delved into the impact of stress on skin cancer development. This retrospective study sought to expand the perspective on skin cancer risk factors by investigating the complex relationship between stressful life events and the incidence of skin cancer. The sample included 268 individuals followed-up in a dermatological clinic, in three groups: Patients who had previously been diagnosed with cutaneous melanoma and are currently in remission (32%), those who had been diagnosed with non-melanoma skin cancer (30%), and a control group who are at risk for skin cancer (38%). Participants filled in questionnaires regarding childhood and adulthood life events, and loss and gain of resources following their subjectively most stressful event in adulthood. Multinomial logistic regression was used to examine the associations of life events with skin cancer occurrence, and mediating and moderating effects of resource loss/gain. Adverse childhood experiences were associated with melanoma occurrence, with the melanoma group reporting significantly more such experiences compared to the control group (p<0.001). Resource loss from subjectively significant stressful life events in adulthood partially mediated the association between adverse childhood experiences and melanoma incidence. The findings suggest that there may be intricate connections between stress, life events, adaptation to change, and skin cancer, which future research may further unravel. This study underscores the need for a more comprehensive approach to stress management, coping strategies development, and skin cancer prevention in healthcare settings.

Examining relationships between adverse childhood experiences and coping during the cost-of-living crisis using a national cross-sectional survey in Wales, UK

ObjectivesAdverse childhood experiences (ACEs) can affect individuals’ resilience to stressors and their vulnerability to mental, physical and social harms. This study explored associations between ACEs, financial coping during the cost-of-living...

Adversity and suicidality during youth

ABSTRACT This analysis examined relationships between childhood adversities and the odds of suicide attempt(s) prior to age 17. Respondents (N = 2072) completed the survey through Amazon’s Mechanical Turk crowdsourcing platform. The sample was represented disproportionately by young adult women who identified as Caucasian. The sample was differentiated into subsets with versus without suicide attempt(s) prior to age 17. Suicide attempt(s) in this sample (22.4%) varied in number (once, n = 200; 9.7%; twice, n = 114, 5.5%; multiple, n = 150, 7.2%). The odds of suicide attempt(s) prior to age 17 were significantly (p < .001) higher for respondents reporting childhood sexual abuse (OR = 5.0), physical abuse (OR = 4.9), emotional abuse (OR = 3.7), peer bullying (OR = 3.1), parental neglect (OR = 1.6), and maternal battering (OR = 2.15). All adversities but exposure to maternal battering accounted for unshared variance in suicide attempts prior to age 17. Adverse Childhood Experiences Questionnaire exposure counts were associated with child and adolescent suicide attempts. Suicide risk did not appear to increment progressively by additional exposures after two co-occurring stressors. The odds of early suicide attempt(s) were markedly higher in this sample among respondents who were exposed to one or more forms of childhood adversity.

Profiles of childhood trauma: epidemiological survey results of an educated young community cohort

Background: Childhood trauma is a major threat to the welfare and prosperity of any society. Young adult population is vulnerable due to increasing adverse childhood experiences and the likelihood of serious implications in educational performance and mental health. This survey was aimed to observe the proportion of various types of childhood traumas and their association with different socio-demographic characteristics among young university students of Karachi, Pakistan. Methods: This cross-sectional study was conducted among 300 young university students, during August-December 2023. Initially, cluster sampling was done deemed to the epidemiological survey. Afterwards, from the selected clusters, students from different universities were approached using non-probability convenient sampling technique. Self-reported data were collected through a questionnaire comprising of socio-demographic characteristics along with the types of traumas experienced during their childhood. SPSS Version 26.0 was used to analyse data. Results: Of the 300 university students with a mean age of 22.14±2 years, 55.3% were females. Overall, 63.6% of the participants experienced trauma before 18 years age. The most common trauma types reported were physical/verbal abuse (81%), unlawful touch/sexual abuse (45%), parents separated/divorced (31%) abandoned by parents (20%), lived with an alcoholic/drug addict (18%) or with a mentally ill adult (14%). There were no statistically significant findings between childhood trauma experience and socio-demographic traits. Conclusions: Various profiles of childhood trauma were found prevalent in young university level individuals. Current research does suggest a way forward to prevent this public health issue that can have detrimental consequences on an individual’s mental and physical health and stress reactivity.

A Narrative Review of the Efficacy of Interventions for Emotional Dysregulation, and Underlying Bio–Psycho–Social Factors

In this narrative, comprehensive, and updated review of the literature, we summarize evidence about the effectiveness of interventions aimed at reducing emotion dysregulation and improving emotion regulation in children, adolescents, and adults. After introducing emotion dysregulation and emotion regulation from a theoretical standpoint, we discuss the factors commonly associated with emotion regulation, including neurobiological and neuropsychological mechanisms, and the role of childhood adverse experiences and psycho–social factors in the onset of emotion dysregulation. We then present evidence about pharmacological and non-pharmacological interventions aiming at improving emotion dysregulation and promoting emotion regulation across the lifespan. Although our review was not intended as a traditional systematic review, and the search was only restricted to systematic reviews and meta-analyses, we highlighted important implications and provided recommendations for clinical practice and future research in this field.

Two-part models identifying predictors of cigarette, e-cigarette, and cannabis use and change in use over time among young adults in the US.

Limited longitudinal research has examined differential interpersonal and intrapersonal correlates of young adult use and use frequency of cigarettes, e-cigarettes, and cannabis. This study aimed to address these limitations. We analyzed five waves of longitudinal data (2018-2020) among 3006 US young adults (Mage = 24.55, 44% male, 32% sexual minority, ~30% racial/ethnic minority). Two-part latent growth models examined likelihood of past-month cigarette, e-cigarette, and cannabis use (binary part) and days used (continuous part) and identified predictors (depressive symptoms, personality traits, adverse childhood experiences [ACEs], parental use) of baseline use and changes over time. Regarding baseline past-month use (27% cigarettes, 38% e-cigarettes, 39% cannabis), depressive symptoms, ACEs, and parental substance use predicted use outcomes (i.e., likelihood, frequency) for each product; extraversion predicted cigarette and e-cigarette use outcomes; openness predicted e-cigarette and cannabis use outcomes; conscientiousness negatively predicted cigarette and cannabis use outcomes; and agreeableness negatively predicted cannabis use frequency. Regarding longitudinal changes, conscientiousness predicted accelerated increase of cigarette use frequency at later timepoints; depressive symptoms predicted increases in likelihood of e-cigarette use but the association weakened over time; and parental cannabis use predicted decreased cannabis use frequency but the association weakened over time. Young adult substance use interventions should target high-risk subgroups and focus on distinct factors impacting use, including chronic, escalating, and decreasing use. This study advances the literature regarding distinct predictors of different substance use outcomes and provides unique data to inform interventions targeting young adult cigarette, e-cigarette, and cannabis use.

The relationship between adverse childhood experiences and social anxiety disorder symptoms: the mediating role of rumination

AbstractThis study aimed to examine the mediating role of rumination in the relationship between adverse childhood experiences and social anxiety disorder symptoms. In this study, which was conducted with correlational design, one of the quantitative research methods, 878 participants were reached. 78.2% of the participants are women and 21.8% are men. In the study, self-report scales consisting of a personal information form, adverse childhood experiences scale, rumination scale, and Liebowitz social anxiety scale were administered to the participants. The analysis of the data regarding the research findings was carried out using the SPSS 25 package program. First of all, the relationship between adverse childhood experiences and social anxiety and rumination was examined; Then, parallel multi-agent analysis and serial intermediary analyses were performed using the Process V4.2 extension (Model 4). According to the findings, it was found that there was a significant positive relationship between adverse childhood experiences, social anxiety disorder symptoms, and rumination variables. It has also been observed that rumination has a mediating role in the relationship between adverse childhood experiences and social anxiety disorder symptoms. Examining the role of rumination in the relationship between childhood adverse events and social anxiety symptoms may help develop new interventions targeting SAD and expand the literature on the cognitive, behavioral, and affective vulnerabilities that early adverse events bring with them.

Sex Differences in the Effects of Adverse Childhood Experiences on Institutional Misconduct among Adults in Prison.

Research from the past few decades has highlighted the long- and wide-reaching effects of adverse childhood experiences (ACEs). These experiences can negatively affect mental and physical health, as well as behaviors and interpersonal relationships well into adulthood. While it is generally understood that ACEs are prevalent in correctional populations, no prior studies have measured this issue using a large representative and racially and ethnically diverse sample of both male and female adult correctional populations in the United States. The data used for this study were collected via an assessment administered to more than 2,100 adults in Minnesota's prison system. Descriptive findings revealed that multiple and varied forms of ACEs were common in the histories of this state's incarcerated population, particularly among females and incarcerated persons who identified as Black, White/non-Hispanic, and American Indian/Alaskan Native. The multivariate results revealed that past exposure to ACEs increased the likelihood and speed of disciplinary convictions after admission to prison for males, but not for females. Overall, the results underscored the importance of assessing for responsivity factors upon admission to prison, including ACEs.

Allostatic load, adverse childhood experiences, executive functions, and BMI status in adolescents and young adults.

Chronic stress induces preclinical changes in the metabolic, cardiovascular, and immune systems. This phenomenon, known as allostatic load (AL), can impair executive functions (EF), which may be even more affected in individuals with excess weight due to their characteristic inflammatory state and cardiometabolic changes. Adverse childhood experiences (ACEs) contribute to AL and may influence executive functioning presumably via alterations within the hypothalamic-pituitary axis, including epigenetic modifications. We assess the relationship between AL and EF in youth with and without excess weight, and the effect ACEs on executive functioning. One hundred eighty-two adolescents and young adults (85 with normal weight and 97 with overweight/obesity; 10-21 years) were recruited. The estimated AL index included the following: systolic and diastolic blood pressure, glycated hemoglobin, high- and low-density lipoprotein cholesterol, triglycerides, high-sensitivity C-reactive protein, fibrinogen, and cortisol. ACEs were measured using the Juvenile Victimization Questionnaire. The neuropsychological evaluation included the assessment of inhibition, working memory, and cognitive flexibility processes. AL was not significantly associated with executive functioning, and this relationship did not depend on body-weight status. ACEs, available for 57 of 182 participants, were significantly associated with poorer executive functioning. Our study shows that AL is not associated with executive functioning in adolescents and young adults. Since the current sample was young, we hypothesize that a longer exposure to AL might be required for its negative effects to surface. Nevertheless, exposure to early adversity seems to be associated with poorer executive functioning in youth.

Risk and protective factors for self-harm and suicide behaviours among serving and ex-serving personnel of the UK Armed Forces, Canadian Armed Forces, Australian Defence Force and New Zealand Defence Force: A systematic review.

Self-harm and suicide behaviours are a major public health concern. Several factors are associated with these behaviours among military communities. Identifying these factors may have important implications for policy and clinical services. The aim of this review was to identify the risk and protective factors associated with self-harm and suicide behaviours among serving and ex-serving personnel of the United Kingdom Armed Forces, Canadian Armed Forces, Australian Defence Force and New Zealand Defence Force. A systematic search of seven online databases (PubMed, Web of Science, Embase, Global Health, PsycINFO, PTSDpubs and CINAHL) was conducted alongside cross-referencing, in October 2022. Following an a priori PROSPERO approved protocol (CRD42022348867), papers were independently screened and assessed for quality. Data were synthesised using a narrative approach. Overall, 28 papers were included: 13 from Canada, 10 from the United Kingdom, five from Australia and none from New Zealand. Identified risk factors included being single/ex-relationship, early service leavers, shorter length of service (but not necessarily early service leavers), junior ranks, exposure to deployment-related traumatic events, physical and mental health diagnoses, and experience of childhood adversity. Protective factors included being married/in a relationship, higher educational attainment, employment, senior ranks, and higher levels of perceived social support. Adequate care and support are a necessity for the military community. Prevention and intervention strategies for self-harm and suicide behaviours may be introduced early and may promote social networks as a key source of support. This review found a paucity of peer-reviewed research within some populations. More peer-reviewed research is needed, particularly among these populations where current work is limited, and regarding modifiable risk and protective factors.

Exploring Independent and Cumulative Effects of Adverse Childhood Experiences on PTSD and CPTSD a Study in Ugandan Adolescents

Exposure to adverse childhood experiences (ACEs) is related to higher morbidity and mortality among adolescents. The present study analyzed the independent and cumulative effects of ACE exposure on the likelihood of PTSD and a CPSTD diagnosis in Ugandan adolescents. A sample of 401 schoolchildren participated in the study. The primary aim was to collect information on ACEs, PTSD, CPTSD, and attachment styles among adolescents living in different countries. It was found that exposure to 2–3 ACEs and exposure to 4–5 ACEs were significantly associated with PTSD diagnosis, while exposure to sexual abuse, bullying, threats of violence, and near-drowning were significantly related to CPTSD diagnosis. Fearful attachment style was significantly associated with PTSD diagnosis. The results propose that biological, psychological, and social issues interact and contribute to the differential prevalence of ACE, attachment styles, and PTSD/CPTSD. This study underscores the importance of addressing childhood-averse and traumatic experiences as a public health priority in Uganda.

Differential effects of gender and ethnicity on children’s receptive language scores after a Canadian two-generation preschool program: follow-up to adolescence

ABSTRACT Preschool programs for socially vulnerable children are believed to affect school readiness and language development but infrequently include follow-up to adolescence; observational measurement of receptive vocabulary is rare. The purpose of this longitudinal cohort study (55 children and 41 parents) was to report the trajectory of receptive vocabulary development for socially vulnerable children of diverse ethnicities (Indigenous, other Canadian-born, and Immigrant) who participated in a two-generation preschool program. English receptive vocabulary scores were measured at 5-time points: (a) program intake, (b) program exit, (c) age 7 years, (d) age 10 years, and (e) adolescence, using the Peabody Picture Vocabulary Test – Third Edition (PPVT-III). For all children, PPVT-III scores increased the most between program intake and exit and positive changes were sustained until adolescence. When the sample was examined by gender, PPVT-III scores were higher for boys than girls at all time points. When the sample was examined by ethnicity, other Canadian-born children scored higher than Indigenous and Immigrant children at all time points. Immigrant children scored lowest until age 7 years, and at age 10 years and adolescence scored higher than Indigenous children. Using mixed-effects modeling, PPVT-III scores increased when English was the primary language spoken at home at intake. PPVT-III scores increased slightly as caregiver age and caregiver Adverse Childhood Experiences score increased. PPVT-III scores were lower for Immigrant girls and Indigenous boys than other sub-groups of children. Differential effects of the two-generation preschool program by gender and ethnicity suggest tailoring programming to increase equitability of receptive vocabulary development for immigrant girls and Indigenous boys. Children with intergenerational adversity may require additional support.

Adverse childhood experiences and dental cleaning during pregnancy: Findings from the North and South Dakota PRAMS, 2017-2021.

Research demonstrates that adverse childhood experiences (ACEs)-that is, experiences of abuse, neglect, and household dysfunction-are related to lower preventive dental care utilization in childhood and adolescence. However, limited research has explored the connection between ACEs and preventive dental care utilization in adulthood, and no research has examined this relationship during pregnancy. The current study extends existing research by investigating the relationship between ACEs and dental cleaning and dental care utilization during pregnancy among a sample of women who delivered live births in North Dakota and South Dakota. Data are from the 2017 to 2021 Pregnancy Risk Assessment Monitoring System (PRAMS) in North Dakota and South Dakota (n = 7391). Multiple logistic regression is used to examine the relationship between the number of ACEs (0, 1, 2, 3 or 4 or more) and dental cleaning during pregnancy. Relative to respondents with 0 ACEs, those with 4 or more ACEs were significantly less likely to report having dental care during pregnancy (OR = 0.757, 95% CI = 0.638, 0.898). By racial and ethnic background, the results showed that the significant associations are concentrated among White and Native American respondents. The results suggest that exposure to 4 or more ACEs is associated with a significantly lower likelihood of dental cleaning during pregnancy among women who delivered a live birth in North Dakota and South Dakota. Further investigations are necessary to understand the mechanisms underlying the relationship between ACEs and dental cleaning during pregnancy and replicate the findings in other geographic contexts.

Is trauma research neglecting neurodiverse populations? A systematic review and meta-analysis of the prevalence ACEs in adults with autistic traits

Purpose The prevalence of exposure to adversity is elevated in autistic populations, compared to neurotypical peers. Despite this, the frequency and nature of early adverse experiences are not well understood in autistic adults, with several underlying methodological limitations in the available literature. The purpose of this study is to systematically synthesise and analyse the prevalence of childhood adversity in this marginalised population, in accordance with the adverse childhood experiences (ACEs) framework. Design/methodology/approach Peer-reviewed empirical research articles were systematically searched for from electronic databases and screened against established inclusion criteria. Pooled prevalence rates for individual ACE types were calculated. Findings Four papers were included (N = 732), all of which used a predominantly or exclusively female sample. Only sexual abuse was reported in all papers, with a pooled prevalence rate of 38%. Physical abuse and emotional abuse were less frequently explored, with two papers reporting on these ACEs, though obtained comparable and higher pooled prevalence rates (39% and 49%, respectively). Pooled prevalence rates could be calculated for neither neglect nor “household” ACEs because of insufficient data. The limited state of the evidence, in conjunction with high levels of heterogeneity and poor sample representativeness found, positions the ACEs of autistic adults as a critical research priority. Originality/value To the best of the authors’ knowledge, this study is the first to systematically synthesise the prevalence of early childhood adversities, as conceptualised in accordance with the ACEs framework, in adults with autistic traits.