Childhood Experiences Research Articles

B - 13 Effects of Individual and Community-Level Adverse Childhood Experiences and Current Psychopathology among Monolingual Spanish-Speaking Adult Neuropsychology Referrals

Abstract Objective The link between adverse childhood experiences (ACEs) and higher rates of psychopathology in adulthood has been well-established, though far less analogue research has examined this relationship among Latinx patients. This study assessed the relationship between ACEs and symptoms of anxiety, depression, and perceived stress among monolingual Spanish-speaking neuropsychology referrals. Method Data were culled from 27 adult neuropsychology referrals (mean age = 61.70; mean education = 8.59) neuropsychological referrals administered the ACE Questionnaire, Beck Depression Inventory (BDI-II), Geriatric Depression Scale (GDS), Beck Anxiety Inventory (BAI), and Perceived Stress Scale (PSS). Linear regression analyses examined the effect of exposure to individual (e.g., emotional, physical, sexual abuse, neglect, domestic violence) and community-level ACEs on depression, anxiety, and perceived stress symptom endorsement. Results Endorsement of more individual ACEs predicted higher levels of anxiety (R2 = 0.281; p = 0.009) and depression (R2 = 0.127; p = 0.075) symptoms, but not perceived stress levels (R2 = 0.037; p = 0.365. By contrast, endorsement of more community-level ACEs marginally predicted higher anxiety symptoms (R2 = 0.124; p = 0.071), but not depression symptoms (R2 = 0.020; p = 0.568) or perceived stress levels (R2 = 0.045; p = 0.319). Conclusions Experiencing more individual-level ACEs predicted greater anxiety and, to a lesser extent, depressive symptoms, whereas community-level ACEs did not predict similar levels of endorsement of active psychopathology among monolingual Spanish-speaking adults referred for neuropsychological evaluation. Findings emphasize the need of neuropsychologists to consider routinely assessing patient’s childhood trauma history and current psychopathology symptoms during evaluation to improve diagnostic accuracy and recommendations for Latinx patients.

A - 40 Food Insecurity Is Associated with Serious Cognitive Difficulties among Adolescents with Attention-Deficit/Hyperactivity Disorder and Learning Disabilities

Abstract Objective Youth with neurodevelopmental disorders, such as attention-deficit/hyperactivity disorder (ADHD) and learning disabilities (LD), experience cognitive difficulties in their daily lives. Food insecurity, a public health problem, disproportionately affects youth with neurodevelopmental disorders and is associated with mental health and academic functioning. We examined the association between parent-reported food insecurity and cognitive difficulty among youth after adjusting for factors associated with cognitive difficulty. Methods The 2022 National Survey of Children’s Health, conducted in the United States, is designed to provide parent-reported information on the health and well-being of children and adolescents. Associations between cognitive difficulty, food insecurity, adverse childhood experiences (ACEs), psychiatric conditions, flourishing, receiving federal assistance, and low socioeconomic status were analyzed using binary logistic regressions. Results There were 6422 youth (aged 6–17) with ADHD and/or LD (63.4% boys). Around half had parent-reported serious cognitive difficulties (50.5%). A third (31.9%) were reported to have mild food insecurity and 6.7% had moderate/severe food insecurity. In the multivariable model [χ2(6) = 1138.25, p < 0.001; Nagelkerke R2 = 0.22], food insecurity [Odds Ratio (OR) = 1.21; 95% confidence interval (CI) = 1.07–1.34)] was an independent predictor of serious cognitive difficulty, in addition to ACEs (OR = 1.121, 95%CI = 1.075–1.168), anxiety or depression (OR = 2.279, 95%CI = 2.041–2.545), flourishing (OR = 0.473, 95%CI = 0.442–0.505), and free or reduced school meals (OR = 1.244, 95%CI = 1.108–1.397). Conclusion Food insecurity was independently associated with parent-reported cognitive problems among youth with ADHD and LD. Better understanding the mechanisms that underlie the associations between food insecurity, other social determinants of health, and cognitive difficulties can facilitate the development of targeted, evidence-informed interventions to bolster functional and academic outcomes for youth with neurodevelopmental disorders.

Proposed Physiological Mechanisms Underlying the Association between Adverse Childhood Experiences and Mental Health Conditions: A Narrative Review.

Adverse childhood experiences (ACEs; e.g., physical abuse) can impact lifelong mental health both directly and intergenerationally, with effects transmitted from the parent to the child. Several physiological mechanisms have been proposed to explain the impacts of ACEs on mental health. The purpose of this narrative review was to synthesize and critique the peer-reviewed literature on physiological mechanisms proposed to underlie the impacts of ACEs on mental health, specifically: (1) hypothalamic-pituitary-adrenal axis functioning, (2) inflammation, (3) genetic inheritance and differential susceptibility, (4) epigenetics, (5) brain structure and function, (6) oxidative stress, and (7) metabolic profiles. We searched Google Scholar using variations of the terms "adverse childhood experiences", "mechanisms", and "mental health" to locate relevant peer-reviewed literature. We also mined citations of the identified literature to find additional important sources. The role of inflammation in the etiology of mental health conditions among those exposed to ACEs appeared promising, followed by hypothalamic-pituitary-adrenal axis functioning, brain structure and function, genetics, epigenetics, metabolism, and lastly, oxidative stress. Replication studies that examine the associations among ACEs, genetic inheritance and differential susceptibility, epigenetics, oxidative stress, and metabolism are required to better define links with mental health.

A - 41 Serious Cognitive Difficulties Are Associated with Food Insecurity after Adjusting for Adverse Childhood Experiences among Adolescents in the United States

Abstract Objective Food insecurity, a public health problem, is associated with worse academic and mental health outcomes in adolescents. Correlates of cognitive difficulty among adolescents include neurodevelopmental disorders, psychiatric conditions, and adverse childhood experiences (ACEs). We examined the association between parent-reported food insecurity and cognitive difficulties, after statistically adjusting for neurodevelopmental disorders, psychiatric conditions, and ACEs. Methods The 2021 National Survey of Children’s Health is a parent-reported survey of youth in the United States that addresses their physical and emotional health. Associations between cognitive difficulty, food insecurity, neurodevelopmental and psychiatric conditions, and ACEs were examined using chi-squared tests and binary logistic regressions. Results Participants were 13,448 adolescents (aged 13–17; 48% girls), and 13.5% had parent-reported cognitive difficulties (14.7% of boys and 12.2% of girls). Among those with cognitive problems, 95% had a diagnosis of a neurodevelopmental or psychiatric condition. In the total sample, 21.7% were rated as having mild food insecurity and 3.4% had moderate–severe food insecurity. ACEs were associated with food insecurity and cognitive difficulties. Binary logistic regressions examined the associations between food insecurity and cognitive difficulties after statistically adjusting for sex, ACEs, and neurodevelopmental and psychiatric conditions [χ2(4) = 3941.339, p < 0.001; Nagelkerke R2 = 0.465]. Food insecurity was independently associated with cognitive difficulty (Odds Ratio = 1.28; 95% confidence interval = 1.15–1.42). Conclusion Food insecurity was associated with serious cognitive difficulty among adolescents in the United States after adjusting for sex, neurodevelopmental or psychiatric conditions, and ACEs. It is important to better understand the correlates of cognitive difficulties among adolescents to bolster precision care designed to support youth with these difficulties.

A - 99 Examining the Relationship between Adverse Childhood Experiences, Neuropsychological Functioning, and Neurocognitive Status among Older Adults

Abstract Objective Adverse childhood experiences (ACEs) are associated with poorer cognitive and mental health outcomes in adulthood. However, there is limited research elucidating the relationship between ACE severity and specific neuropsychological outcomes among examinees with cognitive impairment. This study assessed the relationship between ACE exposure and cognitive and psychiatric outcomes among older adults with and without cognitive impairment. Method This cross-sectional study included 75 patients (64% female; MAge = 67, SD = 8.6; MEducation = 12.8, SD = 3.2) undergoing neuropsychological evaluation at an academic medical center. Analyses of variance (ANOVAs) compared high versus low ACE groups on specific tests of verbal fluency, processing speed, working memory, executive functions, and on depression and anxiety measures. Groups were formed based on neurocognitive status (i.e., no diagnosis, mild cognitive impairment, dementia) and ANOVAs were re-run for each diagnosis. Results No significant differences were detected on neurocognitive measures among the overall group or when groups were subdivided by diagnosis. Among the overall sample, significant group differences were detected for depression and anxiety symptoms, F(1,73) = 16.696, p < 0.001 and F(1,73) = 12.268, p = 0.001 respectively, such that higher ACE groups endorsed significantly more psychiatric symptoms. Among the no-diagnosis group, depressive symptoms were bordering insignificance, p = 0.048, and no differences were detected for anxiety. By contrast, higher ACEs were associated with greater anxiety among the mild cognitive impairment group and greater depression among the dementia group. Conclusions Findings reinforce the impact of ACEs on psychiatric symptoms among older adults. Although there were no significant cognitive differences, further research is necessary to better understand the relationship between ACEs, neurocognitive impairment, and psychiatric functioning.

B - 78 Examining how Adverse Childhood Experiences and the Underlying Processes of Trait and State Impulsivity Influence Suicidal Behavior

Abstract Objective This study sought to better understand how ACEs, suicidal behavior, and impulsivity are interconnected by first examining the relationships between reported ACEs and levels of trait and state impulsivity as well as how ACEs and multiple dimensions of trait and state impulsivity influence suicidal behavior. Method 311 participants (19–67 years old; 49.2% male; 40.2% Caucasian) were recruited through Amazon’s Mechanical Turk. Adverse Childhood Experiences and suicidal behaviors were assessed using the ACE-Q and SBQ-R. The short version UPPS-P scale was used to measure negative urgency, lack of premeditation, lack of perseverance, sensation seeking, and positive urgency whereas behavioral lab tasks were used to measure prepotent response inhibition, delay discounting, and distortions in elapsed time. Results Simple bivariate regressions revealed ACEs are a significant predictor of prepotent response inhibition and total S-UPPS-P scores as well as the specific subscales of negative urgency, positive urgency, and sensation seeking. Furthermore, a hierarchical regression found total ACE scores, poor time perception, and the tendency to act rashly while experiencing negative emotions (negative urgency) to be significant predictors of total suicidal behavior scores. Lastly, an ordinal logistic regression suggests a greater likelihood that individuals will go from suicidal ideation to planning, and from planning to attempting when they tend to act rashly while experiencing negative emotions, have less regard for consequences (lack of premeditation), and have experienced more ACEs. Conclusion By identifying the specific risk factors for suicidal behavior, we can recognize individuals at greater risk of attempting, as well as target and mitigate the effects of these behaviors through intervention.

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

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

Clinician actions in response to Adverse Childhood Experience (ACE) screening

Background and ObjectiveAdverse Childhood Experiences(ACEs) have a powerful influence on mental health, physical health, and life expectancy. Screening for ACEs and the clinician response to ACEs are critical to addressing the health and well-being of children; however, little is known about the actions clinicians take in response to ACE screening. Therefore, we aimed to examine clinician responses to ACE screening at five California pediatric clinics in a large public health care system. MethodsPatient demographics, indicators of social and behavioral determinants of health (e.g., housing insecurity), the number of ACEs endorsed on a screening instrument, and the actions clinicians took in response to each ACE screen were collected. Data was collected from May to October 2021. These data were used to examine the association between number of ACEs reported and clinician response, controlling for patient demographics and their social and behavioral determinants of health using multiple logistic regression. ResultsFive participating pediatric clinics conducted 2,652 ACE screens in six-months. Clinicians documented an action twice as often when ACEs were present, after controlling for patient demographics and their social and behavioral determinants of health (odds ratio(OR) = 2.2, 95 % confidence interval(CI): 1.5–3.3, p-value < 0.0001). Clinicians were three times more likely to record referrals to mental health clinicians, social workers, and community organizations relative to anticipatory guidance when the number of ACEs increased from one to three to four or more (OR=3.2, 95 %CI: 1.6–6.5, p < 0.0001). ConclusionFindings provide early information that ACE screening results are associated with patient care.

Early maladaptive schemas mediate the relationship between severe childhood trauma and eating disorder symptoms: evidence from an exploratory study

BackgroundChildhood trauma history has frequently been linked to eating disorders (EDs); nevertheless, the scientific literature calls for extending knowledge regarding mediators between EDs and childhood trauma. This study explored whether ED symptoms and early maladaptive schemas were more severe in ED patients with severe childhood trauma than in ED patients with no/mild childhood trauma and whether early maladaptive schemas mediated the relationship between childhood trauma and ED symptom severity.MethodsData were extracted from the Regional Centre for Eating Disorders registry at the University Hospital of Verona. The extracted data included self-reported data, including the Eating Disorder Inventory-3 score, Young Schema Questionnaire score, Childhood Experience and Experience of Care and Abuse Questionnaire score, and sociodemographic and clinical information on the ED outpatients seeking care. A mediation analysis using the structural equation modeling procedure was conducted.ResultsForty-two outpatients, 31% of whom exhibited severe childhood trauma, satisfied the criteria for registry data extraction. The severity of ED symptoms, as well as the early maladaptive schemas’ scores for emotional deprivation, defectiveness, failure, vulnerability, insufficient self-control, and negativity, were greater in ED outpatients with severe childhood trauma. Furthermore, early maladaptive schemas related to defectiveness, failure, and negativity had a mediating role in the relationship between severe childhood trauma and ED symptom severity.ConclusionsThis exploratory study provides preliminary evidence about the importance of early maladaptive schemas in the relationship between trauma history and ED psychopathology. In addition, ED symptoms may represent a dysfunctional attempt to avoid unpleasant emotions associated with schema activation. The results support the need to consider early maladaptive schemas in the treatment of traumatized patients with ED symptoms. Study limitations, research and clinical implications are discussed.

Experiences of Rural-Dwelling Children Wearing Physical Activity Trackers: An Exploratory Study.

Although there is a need for evidence-based physical activity programs in rural communities, evaluating such programs is often challenging due to access-related barriers and measurement tools that are not designed for rural contexts. This study aimed to explore and better understand the day-to-day experiences of rural-dwelling children using wrist-worn PA trackers as part of a study to develop a health promotion program. Ten caregivers and child dyads were enrolled (n = 20). The children wore accelerometers pre- and post-intervention. Semi-structured interviews were completed post-intervention and were audio recorded, transcribed, and summary reports were generated based on recurring themes. The children had a mean age of 8.7 (SD = 1.4) years and the majority were male (80%). The caregivers were female, white, and had a mean age of 43.6 (SD = 8.5) years, with an annual income of ≥USD 40,000. Factors contributing to device wear times included low caregiver burden, device functioning as a watch, and device interactivity. The children reported that the devices were acceptable, but may have changed their physical activity behaviors, with children regularly checking their step count. The caregivers preferred devices that monitored the children's activity levels without sharing location data. Identifying acceptable and feasible strategies to measure physical activity is vital to developing effective health promotion efforts. The lessons learned may help develop evaluation plans for implementing rural physical activity programming.

Lived experiences of children who stutter in their own voices

IntroductionSignificant research has explored the lived experiences of adults who stutter, but less research exists regarding the lived experiences of children who stutter. The opinions and ideas of children who stutter may differ from those of adults, making it important for clinicians and researchers to obtain information directly from children who stutter. Asking children directly can lead to treatment outcomes and research questions that better align with the children's needs and values. Method: Interviews with 18 children who stutter (9 girls/9 boys) ages 8–17 were sourced from the Voices of Children Who Stutter database located at Talkbank.org. Interview questions asked the children about living with a stutter, participating in stuttering support organizations (SSOs), and their perspectives on treatment. Qualitative, phenomenological analysis was performed on their answers following standardized qualitative procedures. Results: Analysis of 910 total utterances yielded 7 themes and 9 subthemes. Themes indicated that the children: (a) had significant knowledge regarding their own stuttering, (b) had opinions regarding what constituted worthwhile treatment outcomes, (c) were clear about desirable clinician characteristics for working with kids who stutter, and (d) saw the benefits of being part of a community. Conclusions: Themes revealed that overall, children who stutter exhibit deep understanding regarding their experiences with stuttering, which clinicians can harness in person-centered goal setting. Additionally, the participants express the importance of participating in stuttering support organizations.

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

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

‘Handing down of beautiful knowledge’: Yarning with workers about feeding practices and mealtimes in Australian First Nations families

Mealtimes and feeding practices are shaped by culture and have long-term implications for social and emotional wellbeing. To date, there has been little research in Australia that has focused on First Nations families' feeding practices and mealtimes. This co-designed study aimed to explore First Nations' families feeding practices through yarning circles with workers (n = 14) at an Aboriginal Community Controlled Organization. Most workers (79%) were Aboriginal and/or Torres Strait Islander and all worked directly with First Nations families. Using thematic analysis, four themes were inductively identified from the yarns: the importance of childhood experiences, history, and intergenerational knowledges; mealtimes as a point of connection and wellbeing; the impact of structural barriers on feeding practices; and the important roles of First Nations workers supporting families with feeding difficulties. Workers described how First Nations families' feeding practices and mealtimes are informed by cultural values and knowledge that have been passed down through generations. Yet throughout the yarns, participants highlighted the impact of historical and current structural factors (e.g., cost of living, child removal, housing) that affect families' ability to engage in feeding practices that align with their beliefs and culture. Workers described several strengths-based approaches they use to support families, including community-led mealtime groups, liaising with mainstream health services, and providing a respectful space. We propose that the Social and Emotional Wellbeing model is a holistic strengths-based resource for workers to conceptualize First Nations families’ strengths, values, and challenges in relation to feeding and mealtimes. More co-designed research including the perspectives of First Nations families is needed to better understand healthy and culturally aligned feeding and mealtime practices.

Multiple risks for children of incarcerated mothers: A descriptive study

Objectives and ApproachSurvey data suggests that children of incarcerated mothers are exposed to a range of risk factors that can have negative impacts on life-course outcomes. This retrospective cohort study uses a population sample to describe the extent and mix of risk factors to which children of incarcerated mothers are exposed. Administrative data from health, justice, child protective services, births, and deaths were merged for 9,380 children exposed to maternal incarceration and an unexposed comparison group of 22,716 children. Risk ratios and 95% confidence intervals were calculated for birth complications and adverse childhood experiences (ACEs) for children exposed to maternal incarceration compared to those not exposed, adjusted for sociodemographic risk factors. A multiple risk score summed the number of recorded risk factors (0-17) for children with and without maternal incarceration exposure. ResultsCompared to unexposed children, children of incarcerated mothers had a higher risk of preterm birth, low birthweight, and all ACEs, including a 15-times (95%CI 14.2, 16.3) higher risk of exposure to maternal substance use disorders and 18-times (95%CI 16.8, 20.7) higher risk of placement in out-of-home care. Only 1% of children of incarcerated mothers did not experience any of the included risk factors, compared to 26% of unexposed children (p&lt;0.001). ConclusionsChildren of incarcerated mothers disproportionately experience multiple risks, especially maltreatment, placement in out-of-home care, and maternal substance use. ImplicationsThere is a significant public health opportunity to identify and address the needs of children of incarcerated mothers at the points of maternal arrest, sentencing, and incarceration.

The Opioid Crisis, Impact on Children, and Mitigation Strategies

The opioid epidemic continues to make a significant impact on public health across multiple domains. While patients with opioid use disorders (OUD) remain in the face of this epidemic, the effect of the opioid epidemic, including on children and families, remains unheard. The impact of the opioid crisis is felt the most by individuals who do not use opioids themselves, with children being the most vulnerable victims of the opioid epidemic, an aspect of this epidemic that receives far less attention. The socio-ecological model approach is used to increase awareness of the lived experiences of children growing up in households with OUD and to promote the incorporation of treatment considerations based on available research. A literature review was conducted using computer-based searches using PubMed, PsycINFO, Medline, and Google Scholar databases. This entailed searching according to the following keywords (or stems when possible): opioids, opioid overdose, parental opioid use, child maltreatment, resilience, and adverse childhood experiences. Keywords were combined by using the Boolean operators "AND" and "OR.". Additionally, the ancestry approach, where potential studies were identified from the reference sections of existing reviews on the association between opioids and children, was used. Given that prenatal opioid use is extensively studied, and our focus was on lived experiences, studies focused solely on the effects of prenatal opioid use were excluded. Selected studies were varied in scope and methodologies. We reviewed the bibliographies of identified studies for additional studies and used both forward and backward searching. The economic cost of OUD and fatal opioid overdose is staggering and estimated to be about $1.02 trillion. Exposure to parental opioid use in childhood can have a significant impact on children's current and future lives. Conversely, for parents with OUD, children often provide a strong motivation for treatment. Children of adults with OUD are at higher risk of early exposure and initiation of opioid misuse. Opioid exposure in childhood, in turn, is associated with adult opioid misuse and OUD. Screening at healthcare visits is advocated to detect and mitigate the impact of OUD on children. The odds of using school-based mental health services are greater in boys compared to girls. Emerging evidence suggests that boys manifest less resiliency in the face of parental opioid exposure. This indicates a more nuanced understanding of the developmental outcomes of parental opioid exposure.

Do Adverse Childhood Experiences Impact Adult Emotional Regulation and Interpersonal Functioning among Individuals Convicted of Sexual Offences? Implications for Assessment, Treatment, and Prevention

Do Adverse Childhood Experiences Impact Adult Emotional Regulation and Interpersonal Functioning among Individuals Convicted of Sexual Offences? Implications for Assessment, Treatment, and Prevention

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

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

Lifetime Revictimization: Evidence From the Wisconsin Longitudinal Study.

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

Childhood in the Jewish History of Southern Ukraine in 1919–1920: Family Experience of Violence during the Pogroms

The article focuses on how the anti-Jewish pogroms of 1919–1920 affected Jewish children through the lens of family history. It explores demographic data and factors that influenced children and families in Southern Ukraine during that period. The article attempts to reconstruct the children's experience through their parents’ testimonies and the memories of individuals who endured the anti-Jewish pogroms during childhood. It also analyzes how the experience of the anti-Jewish pogroms has transformed in historical memory and its current influence on public opinion.

Insights from user experience and evaluation of a mobile health nutrition intervention for children with autism: A qualitative study.

Children with autism spectrum disorder (ASD) experience high rates of atypical eating behaviours, such as food neophobia. Mobile health (mHealth) interventions have been found to improve communication, behaviour and social skills for children with ASD. However, there is limited evidence examining mHealth nutrition interventions among children with ASD. The present study comprised a qualitative descriptive study that used qualitative content analysis to explore parent and child experiences with a novel mHealth nutrition intervention. Ten parent-child dyads provided user feedback and evaluation of the intervention. Data collection tools included a semistructured interview guide and a quantitative questionnaire with open-ended questions. Data analysis of the interview transcripts and open-ended questionnaire responses was an iterative process that continued until saturation was achieved. Descriptive statistics were used to analyse quantitative questionnaire data. Analysis of the qualitative semistructured interviews led to emergence of three themes: (1) positive intervention outcomes; (2) parent suggestions for improvement; and (3) barriers to engagement. Each theme included subthemes. Questionnaire data revealed the ability to pick rewards and the virtual character that reinforced dietary goals ("Nutrition Ninja") were the most liked components of the application. Sending messages within the application and the Nutrition Ninja game were the least liked components of the application. Collectively, findings indicated that the app served as an interactive tool prompting dietary change and conversations within families. Yet, for some families, the intervention design, resistance to change or child disinterest hindered use and implementation of the intervention.