Adverse Experiences Research Articles

Understanding the User Experience of Lumbar-Support-Assistive Devices in Lower-Back Pain Patients: Design Recommendations

A positive user experience is crucial for enhancing user adherence throughout the utilization of lumbar-support-assistive devices (LSAD). However, there is a lack of research for optimal user experience with LSAD in the existing literature. Therefore, this study aims to explore how patients with lower-back pain use LSAD and assess their satisfaction and overall experience. Based on this, we aim to provide design improvement recommendations for LSAD to researchers in the relevant field. Through in-depth interviews with 14 LSAD users, key themes were identified using reflexive thematic analysis. The results indicate that participants were “somewhat satisfied” with the overall experience with their LSAD. The key factors influencing the LSAD-wearing experience were: (1) key design challenges in improving LSAD (stability, fit and, comfort), (2) providing necessary assistance (potential barriers and prompts), and (3) individualizing needs and balance of design (aesthetics, dimensions, safety, and cleanliness). All participants reported that poor stability, fit, and comfort of LSAD were the main reasons for an adverse experience. It is worth noting that users may encounter potential barriers when initially using LSAD. Furthermore, younger participants perceived pressure related to appearance and expressed concerns about the exposure of their health privacy during social interactions involving the LSAD. Based on these findings, we have proposed a set of comprehensive LSAD design-improvement recommendations, which serve as a foundational reference for future improvements.

Sex-specific cardiac remodeling in aged rats after adolescent chronic stress: associations with endocrine and metabolic factors

BackgroundCardiovascular disease is a leading cause of death worldwide. Rates of cardiovascular disease vary both across the lifespan and between sexes. While multiple factors, including adverse life experiences, impact the development and progression of cardiovascular disease, the potential interactions of biological sex and stress history on the aged heart are unknown. To this end, we examined sex- and stress-specific impacts on left ventricular hypertrophy (VH) after aging. We hypothesized that early-life chronic stress exposure impacts behavioral and physiologic responses that predict cardiac remodeling in a sex-specific manner.MethodsHistological analysis was conducted on hearts of male and female rats previously exposed to chronic variable stress during the late adolescent period (postnatal days 43–62). These animals were challenged with a forced swim test and a glucose tolerance test before aging to 15 months and again being challenged. Predictive analyses were then used to isolate factors that relate to cardiac remodeling among these groups.ResultsEarly-life chronic stress impacted cardiac remodeling in a sex-specific manner. Among rats with a history of chronic stress, females had increased concentric VH. However, there were few associations within the female groups among individual behavioral and physiologic parameters and cardiac remodeling. While males as a group did not have VH after chronic stress, they exhibited multiple individual associations with cardiac susceptibility. Passive coping in young males and active coping in aged males related to VH in a stress history-dependent manner. Moreover, baseline corticosterone positively correlated with VH in unstressed males, while chronically-stressed males had positive correlations between VH and visceral adiposity.ConclusionsThese results indicate that females as a group are uniquely susceptible to the effects of early-life stress on cardiac remodeling later in life. Conversely, males have more individual differences in vulnerability, where susceptibility to cardiac remodeling relates to endocrine, metabolic, and behavioral measures depending on stress history. These results ultimately support a framework for assessing cardiovascular risk based on biological sex and prior adverse experiences.

The cortisol awakening response: regulation and functional significance.

In healthy individuals, the majority of cortisol secretion occurs within several hours surrounding morning awakening. A highly studied component of this secretory period is the cortisol awakening response (CAR), the rapid increase in cortisol levels across the first 30-45 min after morning awakening. This strong cortisol burst at the start of the active phase has been proposed to be functional in preparing the organism for the challenges of the upcoming day. Here, we review evidence on key regulatory and functional processes of the CAR and develop an integrative model of its functional role. Specifically, we propose that, in healthy individuals, the CAR is closely regulated by an intricate dual-control system, which draws upon key circadian, environmental and neurocognitive processes to best predict the daily need for cortisol-related action. Fine-tuned CAR expression, in turn, is then assumed to induce potent glucocorticoid action via rapid non-genomic and slower genomic pathways (e.g., affecting circadian clock gene expression) to support and modulate daily activity through relevant metabolic, immunological and neurocognitive systems. We propose that this concerted action is adaptive in mediating two main functions: a primary process to mobilize resources to meet activity-related demands and a secondary process to help the organism counterregulate adverse prior-day emotional experiences.

Long term effects of peripubertal stress on the thalamic reticular nucleus of female and male mice

Adverse experiences during infancy and adolescence have an important and enduring effect on the brain and are predisposing factors for mental disorders, particularly major depression. This impact is particularly notable in regions with protracted development, such as the prefrontal cortex. The inhibitory neurons of this cortical region are altered by peripubertal stress (PPS), particularly in female mice. In this study we have explored whether the inhibitory circuits of the thalamus are impacted by PPS in male and female mice. This diencephalic structure, as the prefrontal cortex, also completes its development during postnatal life and is affected by adverse experiences. The long-term changes induced by PPS were exclusively found in adult female mice. We have found that PPS increases depressive-like behavior and induces changes in parvalbumin-expressing (PV+) cells of the thalamic reticular nucleus (TRN). We observed reductions in the volume of the TRN, together with those of parameters related to structures/molecules that regulate the plasticity and connectivity of PV+ cells: perineuronal nets, matricellular structures surrounding PV+ neurons, and the polysialylated form of the neural cell adhesion molecule (PSA-NCAM). The expression of the GluN1, but not of GluN2C, NMDA receptor subunit was augmented in the TRN after PPS. An increase in the fluorescence intensity of PV+ puncta was also observed in the synaptic output of TRN neurons in the lateral posterior thalamic nucleus. These results demonstrate that the inhibitory circuits of the thalamus, as those of the prefrontal cortex, are vulnerable to the effects of aversive experiences during early life, particularly in females. This vulnerability is probably related to the protracted development of the TRN and might contribute to the development of psychiatric disorders.

Interpretative structural modeling method: An analysis of influencing factors analysis on the adverse experiences of cardiac surgery patients in the intensive care units

ObjectiveTo construct an interpretation structure model of adverse experiences of cardiac surgery patients in intensive care unit, so as to provide a reference for optimizing the experience of critical patients step by step. MethodsLiterature review, semi-structured interviews, questionnaires and Delphi method were used to summarize and analyze the influencing factors of intensive care experience in cardiac surgery. The explanatory structural model was used to divide the influencing factors into levels and construct the explanatory structural model of adverse experience of cardiac surgery patients in intensive care. ResultsA hierarchical structure model containing 34 elements and 15 levels was constructed, which were divided into Surface level, middle level and root level. ConclusionThe intensive care experience of patients in cardiac surgery department is mainly affected by 34 factors. There are direct or indirect correlations between the influencing factors, and different levels have different effects.

Co-producing an intervention to prevent mental health problems in children and young people in contact with child welfare services

BackgroundChildren and young people (CYP) in contact with child welfare services are at high risk of developing mental health problems. There is a paucity of evidenced-based preventative interventions provided to this population.ObjectiveThis project worked in partnership with CYP, their parents/caregivers and the professionals who support them to co-produce a preventative mental health intervention for CYP in contact with child welfare services.Participants and settingWe recruited a purposive sample of CYP in contact with child welfare services (n = 23), parents/caregivers (n = 18) and practitioners working within child welfare services and mental health services (n = 25) from the North East of England and convened co-production workshops (n = 4).MethodsThis project followed the established principles for intervention development, applying the six steps to quality intervention development (6SQUID) approach. The mixed method research consisted of four work packages with continuous engagement of stakeholders throughout the project. These were: a systematic review of reviews; focus groups with practitioners; interviews with parents/caregivers and CYP; co-production workshops.ResultsWe identified that the primary risk factor affecting CYP in contact with child welfare services is the experience of childhood adversity. The quality of relationships that the CYP experiences with both their parent/caregivers and the professionals involved in their care are considered to be the main factors amenable to change.ConclusionsWe found that a trauma-informed, activity-based intervention with an embedded family-focused component provided to CYP who have experienced adversity is most likely to prevent mental health problems in those in contact with child welfare services.

Patterns of childhood maltreatment and maternal substance use disorder on the development of emerging adult offspring substance use.

Exposure to child maltreatment and maternal substance use disorder represent two highly consequential and co-occurring experiences of family-level adversity for the development of concerning substance use behaviors among offspring. The present study uses latent class analysis to identify how characteristics of childhood maltreatment and maternal substance use disorder naturally cluster. Further, this study investigates how distinct patterns of maltreatment and maternal substance use differentially predict emerging adult substance use in offspring. Participants (N = 405) were drawn from a longitudinal follow-up study of emerging adults who participated in a research summer camp program as children. Wave 1 of the study included 674 school-aged children with and without maltreatment histories, all of whom experienced low socioeconomic status. Patterns of child maltreatment experiences, based on coded Child Protective Services record data, and maternal substance use behaviors, per a diagnostic interview, were used to predict Wave 2 (emerging adulthood) substance use. Results indicated that children who were exposed to a pattern of multitype maltreatment and multitype maternal substance dependence, relative to those exposed to multitype maltreatment alone, reported greater alcohol dependence symptoms during emerging adulthood. Additionally, these same individuals reported greater past-year hard liquor consumption relative to those who experienced chronic, multitype maltreatment and maternal alcohol dependence. These findings highlight how a pattern of maternal polysubstance use and multitype maltreatment is particularly consequential for the intergenerational transmission of substance use behaviors. (PsycInfo Database Record (c) 2024 APA, all rights reserved).

Bolstering family therapy: Assimilating EMDR into ABFT in youth residential treatment.

The psychotherapy field has a long history of integration to improve treatment effectiveness. One type, assimilative integration, offers innovative opportunities to family therapy to incorporate the clinical and research contributions of different approaches. This paper contributes to the literature on integration by exploring how Eye Movement Desensitization and Reprocessing (EMDR) can be assimilated into Attachment-Based Family Therapy (ABFT) for youth in residential psychiatric treatment. ABFT seeks to improve attachment security to parental figures by asking adolescents and young adults to discuss attachment ruptures. This process, specially designed for patients with internalizing disorders, can provoke anxiety, particularly for a patient population that commonly has a history of trauma and adverse life experiences. EMDR is a first-line therapy for post-traumatic stress disorder and has the potential to be effective in treating various other mental health conditions. When patient emotional withdrawal or dysregulation due to breaches in trust between child and parent emerges in ABFT, EMDR may help desensitize associated memories and bolster the family therapy process. The authors provide an overview of both models, and a detailed case study as an example. The paper concludes with a discussion on implications, integration efforts, and limitations.

Identifying the relationship between recreation engagement, bullying, and suicidality in high school students

Bullying is prevalent among adolescents causing significant impacts to adolescent health. Engaging in recreation provides an opportunity for positive health outcomes. This study examined associations among adolescent sex and sexual identity, recreation engagement, bullying, and suicidality. The findings from this paper support that suicidality during adolescence remains elevated. Results demonstrated that cyberbullying is more prevalent than in-person bullying but neither form of bullying influenced suicidality for high school students. Recreation engagement did not show a significant interaction with suicidality, but high school students did report a reduction in recreation engagement. Findings suggest that prevention efforts and further research are needed to minimize the high prevalence of bullying behaviors and suicidality during adolescence. In addition, more research is needed to identify programs that can be implemented in schools and communities that provide outlets for adolescents during the adverse experience of being bullied.

The effect of CEO adverse professional experience on management forecast pessimism

The effect of <scp>CEO</scp> adverse professional experience on management forecast pessimism

Systematic Review of Psychosocial Risk and Protective Factors in Children Reported from Developmental Criminology.

Evidence indicates that persistent transgressive behaviors often begin early in development and increase around age twelve, and warns that children who exhibit transgressive behaviors in childhood or early adolescence tend to develop criminal behaviors in adulthood which makes childhood a critical unit of analysis for timely intervention. The study examines risk and protective factors in childhood related to illegal behavior, through the perspective of developmental criminology. The observation of risk and protective factors in early stages allows us to design interventions that prevent social adjustment problems in children from becoming more complex by maintaining the transgression of social norms over time. Factors identified by developmental criminology can be organized according to ecological systems theory and discussed in relation to previous criminological studies. Using a systematic review based on the PRISMA method, the study identifies 24 updated developmental criminology articles that study early protective factors between birth and age twelve. Risk factors at the individual level include biological, socioemotional, behavioral, symptomatic aspects and adverse life experiences. Individual protective factors include cognitive, socioemotional, and personality development aspects. Risk factors at an interpersonal and contextual level are related to family, school, peers, socioeconomic situation and governance. This review highlights the importance of recognizing risk and protective factors in child development, contemplating interventions at multiple levels where an articulation between the various institutions involved in child care is possible.

A Traumatology Case Study of an Indonesian Theological Student

Indonesian theological students often come to seminary with handful of problems from the onset of their life. The expectation from the traditional Christian family for their children to set the behavior right in the seminary is outdatedly common. This study explores a case of a 21-year-old theological male student who suffered verbal and physical abuse from his parents. During the initial four weeks of therapeutic alliance with the author, the student exhibited traumatic symptoms of severe hostility and somatic re-enactment of past adverse experiences. He had been known to possess talisman and some sacred relics for witchcraft in the past which contemporarily yield nightmare and terror at night. The qualitative case study explored the traumatic problem of the student through a 12-month observation and in-depth interview. Through experiential therapy of gestalt, CBT, and forgiveness therapy in the last seven months, the student showed reduced symptoms of hostility, somatic complaints, and impulse-behavior. The spiritual formation of prayer and meditation of the Scripture have been useful for the patient in dealing with his spiritual problems. Keywords: counselling, trauma, seminary, students, syncretism, theology, therapy

The Healing and therapeutic effects of perioperative bisphosphonate use in patients with fragility fractures: meta-analysis of 19 clinical trials.

Previous evidence suggests that bisphosphonates (BPs) may lower the risk of recurrent fractures and enhance functional recovery in patients with fractures. However, there has been controversy regarding the optimal timing of treatment initiation for patients with fragility fractures. We conducted a meta-analysis to evaluate the available evidence on the use of BPs during the perioperative period and compared it to both non-perioperative periods and non-usage. Electronic searches were performed using PubMed, EMBASE, Web of Science and the Cochrane Library published before February 2023, without any language restrictions. The primary outcomes included fracture healing rate, healing time, and new fractures. We also examined a wide range of secondary outcomes. Random effects meta-analysis was used. A total of 19 clinical trials involving 2543 patients were included in this meta-analysis. When comparing patients with non-perioperative BPs use in 4-6 weeks and approximately 10-12 weeks post-surgically, the overall risk ratios (RRs) of perioperative BPs use for healing rate were 1.06 (95% CI: 0.81, 1.38, p=0.69) and 1.02 (95% CI: 0.94, 1.11, p=0.65), respectively, suggesting no difference in healing rate between perioperative and non-perioperative BP initiation. For healing time, the overall mean difference between perioperative and non-perioperative periods was -0.19 week (95% CI: -1.03, 0.64, p=0.65) at approximately 10-12 weeks, indicating no significant impact of perioperative BP initiation on healing time. In terms of new fractures, the overall RR with BP use was 0.35 (95% CI: 0.17-0.73, p=0.005), when compared to patients without BPs use. This suggests a protective impact of BP use against new fractures compared to patients without BP use. Perioperative BP use was associated with a markedly higher likelihood of having adverse experiences, including fever (RR: 23.78, 95% CI: 8.29, 68.21, p< 0.001), arthralgia (RR: 10.20, 95% CI: 2.41, 43.16, p=0.002), and myalgia (RR: 9.42, 95% CI: 2.54, 34.87, p< 0.001), compared with non-BPs use. Treatment with BP during the perioperative period does not affect the healing process and has positive effects on therapy for patients with fragility fractures. These compelling findings underscore the potential efficacy of BP use during the perioperative period as a viable treatment option for patients with fragility fractures.

A method to assess bullying and harassment as an upstream determinant of construction worker mental health.

Bullying and harassment in the workplace are increasingly recognized as hazardous exposures associated with poor mental health and suicidality. The construction sector has one of the highest rates of suicide among all occupations and is actively engaged in efforts to destigmatize mental health support. However, there has been less focus on reducing factors that may be contributing to poor well-being among construction workers. As a step toward addressing work-related determinants of mental health in construction, we collaborated with a large construction union to survey members about their experiences of abusive conduct. We adapted standardized questionnaires to better suit the sector, such as by assessing "hazing that went too far" and apprenticeship status. Additionally, we included questions on reporting of abuse, concern about the impacts of abuse, and an open-response to allow participants to share their perspectives. We developed and tested a carefully-tailored survey of abusive conduct. The responses to the survey (over 3300, including 500 narrative responses) will facilitate data-driven interventions with the potential to prevent and address abuse. This paper describes the survey development process in collaboration with the union, domains of abuse that are relevant to the construction context, and the survey protocol. Through a collaborative effort, we developed an instrument to understand abusive conduct in construction and benchmark success in reducing adverse experiences of bullying and harassment. We recommend its use throughout the sector to reduce exposure to this well-being hazard.

Adverse childhood experiences and psychological maladjustment in adolescence: The protective role of epistemic trust, mentalized affectivity, and reflective functioning.

Adverse childhood experiences (ACEs) are psychosocial factors acknowledged as significant contributors to health consequences later in adolescence, including psychological maladjustment. The research suggests that, at a transdiagnostic and transtheoretical level, working on restoring epistemic trust (ET), mentalized affectivity (MA), and reflective functioning (RF) in adolescents with ACEs assumes a central role in the therapeutic process. However, there are still few studies that attempted to investigate the specific role of these sociocognitive factors in the detrimental positive association between levels of experienced ACEs during childhood and psychological maladjustment in nonclinical adolescents. A community sample of 306 Italian cisgender adolescents (61.4% assigned females at birth; age range 13-19 years old; Mage = 16.1, SD = 1.64) self-reported ACEs (Childhood Trauma Questionnaire-Short Form), psychological maladjustment (Strengths and Difficulties Questionnaire), ET (Epistemic Trust, Mistrust and Credulity Questionnaire), MA (Brief-Mentalized Affectivity Scale for Adolescence), and RF (Reflective Functioning Questionnaire). A multiple mediation regression analysis has been performed to explore the association between ACEs and psychological maladjustment through the interaction with socio-cognitive factors. ACEs are positive predictors of psychological maladjustment later in adolescence. Regardless of gender differences, epistemic mistrust and credulity, processing and expressing emotions, and uncertainty about mental states mediated this association, while epistemic trust, identifying emotions, and certainty about mental states did not configure as significant mediators. Findings suggest that ET disruptions and deficits in RF are risk factors, while MA is a protective factor within the link between ACEs and psychological maladjustment in adolescence. These links help to specify the role of sociocognitive factors in the development of mental problems in adolescents who have been exposed to adverse experiences in childhood.

Examining the impact of spirituality religious strength on behavioral and emotional health among youth with multiple adverse childhood experiences

PurposeAlthough spiritual/religious strengths (SRS) are widely believed to be a protective factor for youth physical and mental wellness, scant evidence is available regarding how much and in what direction a person’s past adverse experiences can affect the said protection. The study aims to validate the overall protective effect of SRS on health and investigate the mutual effect modification of SRS and accumulated adverse experiences exposure. MethodsThe study is a cross-sectional design utilizing the Child and Adolescent Needs and Strengths (CANS) administered to foster care youth aged between 5 and 17 in a large, mid-western state from July to December 2020. Logistic regressions were used on a gender-balanced working sample of 4,802 youths to model the odds of physical and mental unwellness measured by 12 behavioral and emotional needs (BEN) items in CANS and the combined multi-BENs (MBE) as 4 or more BEN items, given the presence of (a) SRS identified by CANS, (b) past trauma as having 4 or more out of 10 adverse childhood experiences (ACEs) items on the CANS, denoted as multi-ACEs (MAC), and (c) co-occurring SRS and MAC. ResultsPrimarily, the study found supported the protective benefits of SRS as the presence was associated with lower levels of BEN. However, the higher levels of adverse experiences exposure were associated with an attenuation of the relationship between SRS and BEN. Secondarily, females were found to have higher SRS and lower BEN than males; adolescents between 13 and 17 had disproportionally more ACES, greater BEN and lower SRS; Black youth had disproportionally more trauma exposure and higher BEN, but had higher SRS. ConclusionThe findings imply that having spiritual/religious strength helps promote wellbeing among foster care youth. However, it appears the greater levels of traumatic experiences exposure can overwhelm this positive impact. These findings are consistent with the complex literature on the role of spiritual/religious strength in mental health and may help clarify this complex relationship. Trauma-informed intervention should be considered nuanced approaches to address SRS among children and youth who present with these strengths.

The Reward Positivity Mediates the Association Between Adverse Childhood Experiences and Anhedonia in Young Adults With Drug-Naïve Major Depressive Disorder

BackgroundCurrent clinical studies have indicated that major depressive disorder (MDD) concurrent with adverse childhood experiences (ACEs) is associated with greater anhedonia. However, little is known about whether the change in reward sensitivity among young individuals with MDD and ACEs is related to anhedonia. MethodsWe evaluated anhedonia and ACEs in 86 patients with MDD (31 with no or 1 ACE and 55 with 2 or more ACEs) and 44 healthy control participants. Then, participants completed the Iowa Gambling Task during electroencephalography to measure the reward positivity (RewP) and its difference (ΔRewP; gains minus losses). Furthermore, we constructed a mediation model to assess whether aberrant ΔRewP mediated the relationship between ACEs and anhedonia. ResultsCompared with healthy control participants and MDD patients with no or 1 ACE, MDD patients with 2 or more ACEs had the most severe symptoms of anhedonia and impaired decision making and showed significantly reduced reward sensitivity (most blunted ΔRewP). More importantly, ΔRewP mediated the relationship between ACEs and anhedonia in MDD. ConclusionsWe found that the ΔRewP partially mediated the association between ACEs and anhedonia in patients with MDD, which provides evidence for the neurobiological basis of abnormal changes in the reward system in MDD individuals with early adverse experiences.

Defining and distinguishing early life stress, trauma, adversity, toxic and chronic stress and allostatic load: a descriptive review.

Various concepts are used to study the impact of stress on childhood development. These concepts are often used inconsistently or interchangeably. Our main objectives were to determine how selected stress concepts (chronic stress, toxic stress, allostatic load, early life stress, childhood adversity, childhood trauma and adverse childhood experiences; ACEs) are defined, operationalized and described, and to provide a theoretical context to aid the choice for a preferred concept in public health research. For this descriptive review, we systematically searched for literature published before 4 August 2021, on PubMed, Embase and PsycInfo. Two independent reviewers included studies. Exclusion criteria were: no systematic review, not peer reviewed, not published in English, selected stress concepts were no predetermined variable or a substantial topic in the discussion, full text was unobtainable or study described non-human or non-childhood populations. Data extraction forms were used. Descriptives were gathered, publication fields were identified through Journal Citation Reports categories, and verbatim descriptions were ordered in text and Venn diagrams. Of 264 screened studies, 124 were included. ACEs, childhood adversity and childhood trauma were used most. ACEs were the main concept used most frequently (47.6%). A total of 11 of 14 public and environmental health journals used ACEs. All concepts refer to prolonged, repeated, interpersonal stress from 0 to 18 years, that can alter physiological systems. Four concepts were stressor oriented, two concepts focused on stress response and effect and one on the state of challenged homeostasis. ACEs seem most fitting for public health setting, due to their operationalizability, large set of core experiences and widespread use.

Experiences when using different EHMR models: Implications for different designs and meeting user expectations

New elastomeric half-mask respirator (EHMR) models without exhalation valves (EVs) or with exhalation valve filters (EVFs) are facilitating expanded use in health settings to reduce workers' exposure to airborne hazards while acting as source control to prevent pathogen spread. The physical comfort of new models has not been assessed in comparison to previously used EHMRs with EVs. Researchers assessed 1,962 health care and emergency medical service personnels' self-reported adverse experiences from 2 cohorts while wearing EHMR models with EVs (cohort 1, n=1,080) and without EVs or with EVFs (cohort 2, n=882). Fisher exact test identified differences between the cohorts accounting for organizational factors when possible. Cohort 1 respondents experienced communication challenges and discomfort when wearing the EHMR >1hour statistically significantly more often than cohort 2. Cohort 2 respondents reported statistically significantly more instances of difficulty breathing, moisture buildup, being uncomfortable to wear <1hour, and being uncomfortably warm. Discomfort is prevalent among end users and more often among those wearing EHMRs without an EV/with an EVF. As EHMR research and development advances, prevalence in use may increase for emergency and routine situations. Organizations may not only need guidance about respirator selection but also model-specific selection.

Epigenetic Biomarkers for Understanding Adverse Experiences and Health

Epigenetic Biomarkers for Understanding Adverse Experiences and Health