Childhood Household Dysfunction Research Articles

Adverse Childhood Experiences and Suboptimal Self-Rated Health in Adulthood: Exploring Effect Modification by Age, Sex and Race/Ethnicity.

This study examined whether the relationship between adverse childhood experiences (ACEs) and self-rated health among adults in a nationally representative population is modified by age, sex, or race/ethnicity. Cross-sectional study. United States. Data from the 2020 and 2021 Behavioral Risk Factor Surveillance System were obtained from 185731 (weighted N = 47862016) persons 18years or older. The ACE cumulative score (range: 0-11) was calculated using 11 questions about childhood emotional abuse, physical abuse, sexual abuse, and household dysfunction before age 18 and classified as 0 (reference), 1, 2, 3, or ≥4. Self-rated health was divided into (excellent/very good/good [reference]) and suboptimal (fair/poor) categories. Multivariable-adjusted logistic regression was conducted to test for the interaction with age, sex, and race/ethnicity with ACEs. After adjustment for potential confounders, an increasing number of ACEs had statistically significantly higher odds of suboptimal self-rated health in a graded manner except for 1 ACE (1 ACE: aOR:1.09; 95% CI: 1.00-1.20, 2 ACEs: 1.16; 1.03-1.30, 3 ACEs: 1.17; 1.03-1.32 and ≥4 ACEs: 1.39; 1.26-1.53). There was a significant interaction between ACEs and age. Younger age (18-24years) had the strongest association for ≥4 ACEs compared to the older age groups. There was no effect modification by sex or race. ACEs should be considered when creating health-promoting interventions to improve health.

Associations of childhood household dysfunction and healthy lifestyle with depressive symptoms in adolescents

ObjectiveLimited understanding exists regarding the cumulative impact of childhood household dysfunction (CHD) on adolescent depressive symptoms in developing countries, as well as the role of lifestyles in this association. This study aims to explore the associations of individual and cumulative CHD indicators with depressive symptoms among Chinese adolescents. Additionally, we investigate potential interactions and joint associations of CHD and lifestyles on depressive symptoms. MethodsIn the second phase of the Longitudinal Study of Adolescents’ Mental and Behavioral Well-being Research, data on depressive symptoms, CHD indicators, lifestyle factors, and other covariates were collected from 3106 students (mean [SD] age, 15.16 [1.52] years). Linear and logistic mixed-effects models were employed, with both stratified and joint analyses conducted. ResultsExcept for parental death, each CHD indicator was associated with an increased risk of depressive symptoms. The accumulation of CHD indicators exhibited a positive, graded association with depressive symptoms scores (β = 3.22, 95% CI: 2.48 to 3.97 for one CHD indicator; β = 5.45, 95% CI: 4.41 to 6.49 for two or more CHD indicators, all P < 0.01). A significant interaction was found between the number of CHD indicators and the healthy lifestyle score (interaction β = −0.40, 95% CI: −0.78 to −0.03, P < 0.05), indicating that healthy lifestyles may mitigate the risk of depressive symptoms in individuals experiencing CHD. For example, the OR for having depressive symptoms among adolescents with favourable lifestyles compared with those with unfavourable lifestyles was 0.21 (95% CI: 0.10 to 0.45, P < 0.01) among those experiencing CHD. Moreover, adolescents with two or more CHD indicators and unfavourable lifestyles faced the highest risk of having depressive symptoms (OR = 8.03, 95% CI: 4.83 to 13.34, P < 0.01) compared with those with no CHD indicator and favourable lifestyles. ConclusionsThese findings underscore the importance of promoting comprehensive healthy lifestyles and reducing CHD exposure for the prevention of depressive symptoms in adolescents.

Mitigating rACEsm in K-12 Classrooms: The Consideration of Culturally-Informed Adverse Childhood Experiences and Utilization of Culturally Relevant Education and Systemically Trauma-Informed Practice

Forty-six percent of children in the United States experience a potentially traumatic event (PTE), also known as an Adverse Childhood Experience (or ACE), including abuse (physical, sexual, emotional), neglect, and/or household dysfunction (incarceration of a family member, parental mental illness, divorce, etc.) before their 18th birthday. In the United States, 61% of African-American youth experience at least one ACE (more than any other racial or ethnic group), compared with 40% of White children. A culturally informed conceptualization of the ACEs framework (C-ACEs) that considers the effects of historical trauma, racist social conditions, and race-based biological stress on African-American youth is essential. This is particularly important in K-12 Educational institutions for two reasons: (1) Schools are a major environment in which African-American youth are exposed to racial trauma via teachers, peers, policies, and practices within the school itself; (2) Popularity of the “trauma-informed” movement in schools that overemphasizes and overuses the existing ACEs framework (i.e., a “neoliberal biomedical trauma model”) and does not consider larger systems that cause and perpetuate trauma (p. 105). Further, it is essential to review how school teachers, administrators, and staff can amalgamate Systemically Trauma-Informed Practice (SysTIP) with Culturally Relevant Education (CRE) to increase education equity, reduce the trauma of racism experienced within educational spaces, and help ensure that African-American students succeed academically and personally.

Adverse Childhood Experiences, Household Dysfunction and Cirrhosis

Adverse Childhood Experiences, Household Dysfunction and Cirrhosis

Application of trauma-focused cognitive behavioral therapy among children and adolescents with childhood household dysfunction.

Childhood household dysfunction (CHD) is a common adverse childhood experience, which brings the heavy physical and mental afflictions to children and adolescents. Trauma-focused cognitive behavioral therapy (TF-CBT) is an evidence-based psychotherapy that helps children and adolescents who have experienced childhood trauma with traumatic memories. It aims to enhance the coping abilities of CHD children and adolescents, thereby improving the negative effects caused by trauma and effectively reducing psychological burden. TF-CBT can effectively improve post-traumatic stress disorder, emotional and behavioral problems, and family function in children and adolescents with CHD. It is recommended to conduct high-quality original research in the future, develop targeted TF-CBT intervention plans based on potential predictive factors, adopt a combination of online and offline methods, and construct TF-CBT interventions suitable for the Chinese CHD population to meet the mental health service needs of CHD children and adolescents.

GxE interaction effects of HCRTR2 single nucleotide polymorphism and adverse childhood experiences on methamphetamine use disorder

ABSTRACT Background: Methamphetamine use disorder (MUD) is a worldwide health concern. The hypothalamic orexin system regulates stress response and addictive behaviors. The genetic variation in the hypocretin receptor 2 (HCRTR2), rs2653349, is associated with substance use disorder. Objectives: We explored the gene-environment (GxE) interaction of rs2653349 and adverse childhood experiences (ACEs) associated with MUD susceptibility. Methods: Four hundred and one individuals (336 males, 65 females) with MUD and 348 healthy controls (288 males, 60 females) completed a self-report questionnaire evaluating ACEs, encompassing childhood abuse and household dysfunction categories, and were genotyped for SNP rs2653349. Methamphetamine use variables were collected using the Diagnostic Interview for Genetic Studies. We used regression analyses to assess the GxE effect on MUD risk. Results: The MUD group had a comparable genotypic distribution for rs2653349 to the control group, albeit with a higher prevalence and number of types of ACEs, correlating with an increased MUD risk (p < .05). No significant genetic impact of rs2653349 on MUD risk was found. However, we observed a GxE interaction effect between the minor allele of rs2653349 and the number of childhood abuse or household dysfunction types, correlating with a reduced MUD risk (OR = -0.71, p = .04, Benjamini-Hochberg adjusted p = .08 and OR = -0.59, p = .045, Benjamini-Hochberg adjusted p = .09, respectively). Conclusion: HCRTR2 SNP rs2653349 has no significant impact on MUD risk, but ACEs may increase this risk. GxE results suggest that rs2653349 could offer protection against developing MUD in individuals experiencing multiple types of ACEs.

Abstract 16913: The Association Between Adverse Childhood Experiences and Physiologic Age as Determined by Artificial Intelligence-ECG

Background: The gap between electrocardiogram (ECG) artificial intelligence-derived age (ECG-Age) and chronological age (Age-Gap) predicts cardiovascular (CV) comorbidities and mortality reflecting physiologic age. Adverse childhood experiences (ACEs) are traumatic and harmful events that impact adulthood CV outcomes. We hypothesized that ACEs would be associated with physiologic age as determined by the Age-Gap. Methods: We applied a previously validated ECG-Age algorithm to the ECGs of 1,988 consecutive individuals aged ≥18, that within 2 years completed an ACEs questionnaire as part of psychological evaluations for weight management. The ACE questionnaire assesses 3 psychosocial domains (i) childhood abuse (psychological, physical or sexual), (ii) household dysfunction (substance abuse, mental illness, female figure treated violently, criminal behavior and parental separation/divorce) and (iii) neglect (emotional or physical) before age 18; results ranged 0 to 10 and were categorized as burden (0, 1-3, and ≥4) and presence (abuse, household dysfunction, neglect). Age-Gap was operationalized as (≤mean or &gt; mean) positive values reflect physiological aging. Logistic regression analyses tested the association between ACE and Age-Gap. Results: Mean ± SD chronological age was 49±13 yr, ECG-Age 54±12 yr, Age-Gap 4.26±8.95 yr,75% women, average ACE 2±2, 32% experienced 0, 44% 1-3, and 24% ≥4 ACEs. Age-Gap was 1.4 years higher in those who experienced at least 1 ACE. Compared to those who didn’t experience ACE those who faced 1-3 ACE were more likely to have an Age-Gap &gt;mean (OR 1.28 95%CI 1.57-1.04) independent of sex and the age-adjusted Charlson comorbidity index Fig A. Also, they were more prone to experiencing neglect and household dysfunction Fig B. Conclusions: Age-gap was associated with ACEs burden and domains, underscoring the need to identify ACEs during clinical evaluations to prevent ACEs at the individual, family, and community levels.

Adverse childhood experiences, morbidity, mortality and resilience in socially excluded populations: protocol for a systematic review and meta-analysis

IntroductionSocially excluded populations, defined by homelessness, substance use disorder, sex work or criminal justice system contact, experience profound health inequity compared with the general population. Cumulative exposure to adverse childhood...

Psychosocial Factors Associated With Perinatal Anxiety and Perinatal Depression Among Adolescents: A Rapid Review.

The current review examined the influence of psychosocial factors on adolescents' perinatal anxiety (PA) and perinatal depression (PND) across geographical regions. Three databases were searched for articles published between 2017 and 2022 and 15 articles were reviewed. We categorized factors into social, cultural, and environmental domains. Social factors included adolescent caregiver trust/attachment, social support, perceived social support, trauma/poly-traumatization, and peer solidarity. Cultural factors included feelings of shame, marital satisfaction, partner's rejection of pregnancy, lack of parental involvement in care, parenting stress, childhood household dysfunction, and adverse childhood events. Environmental factors included neighborhood support, food insecurity, domestic violence, going to church, going out with friends, and sources for obtaining information. Routine assessment of psychosocial factors among perinatal teens is crucial to identify those at higher risk for PA and PND. Further research is necessary to examine the influence of cultural and environmental factors on PA, PND, and perinatal outcomes among adolescents. [Journal of Psychosocial Nursing and Mental Health Services, 62(2), 13-22.].

Adverse Childhood Experiences and Tobacco Use Patterns Among Adults in the United States: Exploring sex differences.

Adverse childhood experiences (ACEs), which refer to childhood traumatic events, have been identified as risk factors for tobacco use in adulthood. However, studies are limited on the effect of sex on the association of ACEs with e-cigarettes and dual use of e-cigarettes and cigarettes. This study explored sex differences in the association of ACEs with e-cigarettes, cigarettes, and dual use of e-cigarettes and cigarettes among adults in the United States. This was a cross-sectional analysis of data from adults aged ≥18 years in the 2020 Behavioral Risk Factor Surveillance System (N = 62,768). ACEs, the independent variable, was a composite score assessed from 11 questions (with responses yes-1 or no/never-0) related to childhood emotional abuse, physical abuse, sexual abuse, and household dysfunction and categorized as 0 (reference), 1, 2, 3, or ≥4. The dependent variable, tobacco use patterns, included nonuse (reference), e-cigarette only, cigarette only, and dual use of e-cigarettes and cigarettes. Multinomial logistic regression was performed to test the interaction between sex and ACEs while controlling for potential confounders. Although we found no statistically significant interaction by sex, a greater number of ACEs were associated with higher odds of the different tobacco use patterns among females and males, with varying strengths of associations. Specifically, females who reported ≥4 ACEs compared with none had higher odds of e-cigarette (aOR [95% CI]: 3.58 [1.49-8.63]), cigarette (2.57 [1.72-3.83]) and dual use (3.25 [1.79-5.91]) relative to nonuse. Males with ≥4 ACEs had higher odds of cigarette (1.75 [1.15-2.65]) and dual use (7.64 [3.95-14.79]). Our findings underscore the importance of developing appropriate, tailored trauma-informed intervention strategies for females and males. It is also important to consider ACEs in designing tobacco-specific preventive programs to curb initiation and promote cessation among U.S. adults.

Childhood household dysfunction is associated with reduced left ventricular mass in young adulthood.

The effect of adverse childhood experiences (ACEs) on left ventricular mass (LVM) and left ventricular function remains largely unknown across the lifespan. This study investigated the influence of ACEs on LVM and left ventricular function and whether inflammation influences this relationship. Two hundred forty-eight healthy young adults participated and a final sample of 217 (age, 22.6 ± 0.1 yr; females, 114) had complete data. Echocardiographic assessment of LVM was indexed to height2.7 (LVMHT) and body surface area (LVMBSA). Ejection fraction (EF) and fractional shortening were also assessed. Interleukin-6 (IL-6), C-reactive protein, tumor necrosis factor-α, and matrix metalloproteinase (MMP) 1-3 were measured and ACEs exposures were assessed based on exposure and nonexposure to childhood household dysfunction and maltreatment, and quantity of adversity, (i.e., <4 ACEs and ≥4 ACEs). Individuals who experienced household dysfunction demonstrated lower LVM, LVMHT, and LVMBSA (P < 0.01) and greater IL-6 (P < 0.05) than those who did not experience household dysfunction. Reduced MMP3 was present in individuals who experienced maltreatment (P < 0.05) and ≥4 ACEs (P < 0.01) compared with no maltreatment and <4 ACEs, respectively. After controlling for covariates (i.e., sex, recent life stress, height, body mass index, smoking, physical activity, and inflammation), a significant negative effect of household dysfunction on LVM, LVMHT, and LVMBSA persisted. Likewise, a negative effect on EF independent of covariates was observed in individuals who experienced ≥4 ACEs. As such, alterations in LVM and EF may be perpetuated through a toxic home environment, promoting left ventricular underdevelopment in young adulthood. The effect of which in midlife and beyond requires additional investigation.NEW & NOTEWORTHY This is the first study to investigate the influence of adverse childhood experiences (ACEs) on left ventricular mass (LVM) and function. We identified experiencing any childhood household dysfunction was associated with lower LVM in young adults independent of sex, recent life stress, BMI and height, smoking, physical activity, and inflammation. We speculate an inflection point in LVM occurs in midlife predisposing these individuals toward a hypertrophic profile and elevated risk of heart disease in later life, although this requires longitudinal investigation.

Adverse childhood experiences are associated with altered cardiovascular reactivity to head-up tilt in young adults.

Adverse childhood experiences (ACEs) are associated with greater prevalence of cardiovascular disease and altered acute stress reactivity. The current study investigated the effect of ACEs on hemodynamic and autonomic responses to orthostatic stress imposed by 60° head-up tilt (HUT) in young adults. Two-hundred twenty-six healthy young adults (age = 22.6 ± 1.5 yr; n = 116 females) without cardiovascular disease participated and had complete data. Participants underwent supine blood pressure (BP), R-R interval (RRI), cardiac output (CO), total peripheral resistance (TPR), and cardiovagal baroreflex sensitivity (cvBRS) testing followed by a transition to 60° HUT where measures were reassessed. Childhood adversity exposures were assessed based on categorical exposure and nonexposure to childhood household dysfunction and maltreatment, and <4 and ≥4 types of ACEs. Significantly greater increases in SBP (P < 0.05), DBP, MAP, and TPR (P < 0.01; all) following 60° HUT were observed in individuals with ≥4 compared with those with <4 types of ACEs. Attenuated decreases in RRI and cvBRS were observed in those with ≥4 types of ACEs (P < 0.05). Experiencing ≥4 types of ACEs was associated with augmented BP and TPR reactivity and a blunted decrease in cvBRS in response to 60° HUT in young adults. Results suggest that a reduced vagal response to orthostatic stress is present in those who have experienced ≥4 types of ACEs that may promote autonomic dysfunction. Future research examining the sympathetic and vagal baroreflex branches is warranted.

Childhood abuse, neglect, household dysfunction, and juvenile recidivism: The mediating role of social bonds

PurposeThough prior research has found a connection between Adverse Childhood Experiences (ACEs) and offending, only a few studies have investigated potential mediators that may help explain these effects. The current study builds upon childhood abuse research that has found social bonds to be a mediator between childhood maltreatment and offending and examines the extent to which social bonds represent an intervening variable between ACEs and recidivism.Methods: Using a sample of first-time adjudicated youth and an expanded measure of social bonds, a structural equation modeling (SEM) path analysis of the ACEs → social bonds → juvenile recidivism relationship was conducted. ResultsThe models revealed partial support for mediation- the indirect effect of ACEs on recidivism via social bonds was marginally significant. Further, it was found that 32% of the total effect of ACEs on recidivism operated through a youth's social bonds. ConclusionsThese findings highlight one potential mechanism of the ACE-offending relationship and further implications of this indirect relationship are discussed.

Adverse and Benevolent Childhood Experiences Predict Prenatal Sleep Quality.

The objective of the study was to investigate whether adverse and benevolent childhood experiences were associated with trajectories of sleep quality throughout pregnancy. The study was conducted at obstetrics and gynecology clinics in the Rocky Mountain region of the USA. The participants of the study were pregnant individuals (N = 164). Sleep quality was measured with the Pittsburgh Sleep Quality Index at three gestational time points, and adverse childhood experiences (ACEs) and benevolent childhood experiences (BCEs) were assessed once. Multilevel models were conducted to examine the trajectory of sleep quality across gestation in relation to ACEs and BCEs. Sleep quality was similar in early to mid-pregnancy, with a worsening of sleep quality late in pregnancy, following a quadratic trajectory. Higher levels of ACEs predicted poorer prenatal sleep quality (b = 0.36, SE = 0.13, p = .004) throughout pregnancy, while higher levels of BCEs predicted better sleep quality (b = -0.60, SE = 0.17, p < .001) throughout pregnancy. Examination of ACEs subtypes revealed that childhood maltreatment predicted poor sleep quality (b = 0.66, SE = 0.18, p < .001), while childhood household dysfunction was not significantly associated (b = 0.33, SE = 0.21, p = .11). Associations remained after covarying for socioeconomic status and current stressful life events. Both adverse and benevolent childhood experiences predict sleep health during pregnancy. Prevention and intervention strategies targeting resilience and sleep quality during pregnancy should be implemented to promote prenatal health and well-being.

The Mediating and Moderating Roles of Life Skills and Cortisol in the Relationship Between Sleep Quality and Depressive Symptoms Among Chinese Adolescents With Childhood Household Dysfunction.

BackgroundVarious studies show that sleep quality, life skills, and cortisol are associated with depressive symptoms, separately. However, the relationships between sleep quality, life skills, cortisol, and depressive symptoms remain unclear. Thus, this study aims to examine the mediating or moderating roles of life skills and cortisol in the relationship between sleep quality and depressive symptoms.MethodsA retrospective cross-sectional study was performed among 212 adolescents with childhood household dysfunction (CHD) from August to October 2020 in China. We used the Pittsburgh Sleep Quality Index, the Secondary School Student Life Skills Rating Scale, and the Center for Epidemiologic Studies Depression Scale to measure sleep quality, life skills, and depressive symptoms, respectively. Additionally, 65 participants provided blood samples to assess their blood cortisol levels. Analyses included correlations, regressions, and structural equation models. Bootstrapping was performed to examine the mediation effect. Multiple regression analysis was performed to examine the moderation effect.ResultsThe results showed that sleep quality and life skills were significantly associated with depressive symptoms (p < 0.01). Life skills mediated the relationship between sleep quality and depressive symptoms. Cortisol moderated the relationship between sleep quality and depressive symptoms.ConclusionOur findings support potential mediating and moderating roles of life skills and cortisol in the relationship between sleep quality and depressive symptoms, which suggests improving sleep quality, life skills are of great significance in the prevention and intervention of depression in adolescents with CHD, and disseminating knowledge about the high risk of developing increased depressive symptoms among adolescents with CHD with higher cortisol levels is indicated.

Social-Ecological Correlates of Social Isolation as a Structural Indicator of Social Connectedness Among Young Adult U.S. Males.

We examined the intrapersonal, interpersonal, community, and societal correlates of a structural indicator of social connectedness (ie, social isolation) among a sample of young adult U.S. males. Cross-sectional. Setting: Online survey. Males (n = 495) aged 18-25years residing in the U.S. Social isolation was assessed as an index measure of social integration (inverse scored). The correlates consisted of the following variables: 1) intrapersonal (eg, social-demographic characteristics), 2) interpersonal (eg, adverse childhood experiences; marital status), 3) community (eg, county-level mental distress rates), and 4) societal (eg, how powerful is society's image of the 'masculine man'). Four-block hierarchical regression. The intra- and interpersonal variables significantly shared 17% and an incremental 5%, respectively, of the explained variance in social isolation. Several intra- (eg, financial vulnerability β = -2.76, [95% CI: -4.40, -1.13]) and inter-personal (ie, childhood household dysfunction β = -.66, [95% CI: -1.18, -.14]) factors were significantly associated with greater social isolation. Four intrapersonal factors (eg, gay or bisexual β = 2.31, [95% CI: .29, 4.33]) were significantly associated with lower social isolation. The current study's findings have important implications for understanding and shaping social connectedness in young adult U.S. males, with micro-level influences potentially being most important in predicting social isolation in this population.

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

Distinct Psychological Profiles Linking Childhood Adversity and Substance Misuse in High-Risk Young Adults

Adverse childhood experiences (ACEs) constitute a key determinant in the development of substance misuse. However, the understanding of how ACEs cultivate this risk lacks the specificity needed to inform effective prevention and intervention practices. This issue may be remedied by exploring the distinction between ACEs and their effects on development. The present study investigated whether distinct patterns of adversity are differentially associated with substance misuse along unique profiles of psychological variables, namely anxiety and punishment sensitivity – an internalizing profile – versus reward sensitivity and executive functioning – an externalizing profile. Using a cross-sectional retrospective design, 124 high-risk young adults completed assessments of childhood adversity and psychological functioning. We employed the ACE-IQ to capture extended ACEs such as community and collective violence, as our sample grew up in the post-conflict society of Northern Ireland. Exploratory Factor Analysis revealed three patterns of adversity co-occurrence – Childhood Maltreatment, Household Dysfunction and Community Adversity, all of which independently predicted different types of substance misuse. Childhood Maltreatment was significantly associated with heavy drug use probability; Household Dysfunction was associated with cannabis dependence probability; and Community Adversity was associated with both cannabis dependence and heavy drug use probability. Logistic regressions (all p < .05) showed that heavy drug use probability was predicted by Childhood Maltreatment and anxiety in one model, and by Community Adversity and reduced punishment sensitivity in another, suggesting that different types of ACEs were associated with partially distinct outcomes in this sample. These results support the proposal that different ACE subtypes confer distinct effects, which carries clinical implications for substance misuse prevention and intervention.

Does screening for maternal ACEs in prenatal care predict pregnancy health risk above and beyond demographic and routine mental health screening?

BackgroundAdverse childhood experiences (ACEs), including abuse, neglect, and/or household dysfunction, are associated with physical and mental health difficulties in pregnancy and the postpartum period. These associations have prompted the adoption of screening for ACEs in prenatal care settings; however, little is known about whether asking about ACEs in the prenatal care context is additive to other forms of routine prenatal demographic and mental health screening. ObjectiveTo identify whether ACEs are predictive of cumulative pregnancy health risk and identify whether ACEs predict maternal health risks in pregnancy above and beyond screening for financial stress, depression, and anxiety. Participants and settingThe electronic medical records of three hundred and thirty-eight patients who accessed prenatal care at a low-risk primary care maternity clinic were included. MethodsWomen retrospectively self-reported their ACEs during their second prenatal primary care visit (~20 weeks' gestation) and reported financial stress as well as their depressive and anxious symptoms using the PHQ-2 and GAD-2. Health risk factors and complications were documented by healthcare providers in the files at birth. Approximately 32% of patients reported at least one ACE. ResultsRegression analyses revealed that after accounting for financial stress, neither depression nor anxiety predicted cumulative health risk in the antenatal period. ACEs significantly predicted cumulative health risk (B = 0.14, p = .02) and an additional 1.7% of variance in the outcome. However, the model only accounted for 5.0% of the variance in cumulative health risk. ConclusionsThe total health risk predicted by demographic and ACEs screening is modest in this low-risk sample. Additional research on the implications of broader trauma-informed approaches is needed to evaluate their impact.

Classes of lifetime adversity in emerging adult women and men and their associations with weight status

The aim of this paper was to better understand how child and adult adversities cluster together into classes, and how these classes relate to body weight and obesity. Analyses included 2015 and 2018 data from emerging adults (18–25 years old) who participated in a state surveillance system of 2- and 4-year college students in Minnesota (N = 7475 in 2015 and N = 6683 in 2018). Latent Class Analyses (LCA) of 12 child and adult adversities were run stratified by gender and replicated between 2015 and 2018. The distal outcome procedure and three-step Bolck-Croon-Hagenaars approach were used to estimate predicted BMI means and predicted probabilities of obesity for each class, adjusted for covariates. The LCA identified seven classes in women and 5 in men. In women, BMI ranged from 23.9 kg/m2 in the lowest-BMI class (“Adult Adversities and Childhood Household Dysfunction”; 95% CI: 22.6–25.1) to 27.3 kg/m2 in the highest-BMI class (“High Lifetime Adversities”; 95% CI: 25.9–28.7), a statistically significant difference of 3.4 kg/m2. In men, the adjusted BMIs ranged from 24.6 kg/m2 (“Low Adversities”; 95% CI: 24.3–25.0) to 26.0 kg/m2 (“Childhood Household Mental Illness”; 95% CI: 25.1–26.9), a statistically significant difference of 1.4 kg/m2. The pattern was similar for obesity. These results indicate that specific classes of child and adult adversities are strongly associated with BMI and obesity, particularly in women. A key contribution of LCA appeared to be identification of small classes at high risk for excess weight.