Higher Adverse Childhood Experiences Scores Research Articles

Pathways between early-life adversity and adolescent self-harm: the mediating role of inflammation in the Avon Longitudinal Study of Parents and Children.

BackgroundAdverse childhood experiences (ACEs) such as physical and emotional abuse are strongly associated with self‐harm, but mechanisms underlying this relationship are unclear. Inflammation has been linked to both the experience of ACEs and self‐harm or suicide in prior research. This is the first study to examine whether inflammatory markers mediate the association between exposure to ACEs and self‐harm.MethodsParticipants were 4,308 young people from the Avon Longitudinal Study of Parents and Children (ALSPAC), a population‐based birth cohort in the United Kingdom. A structural equation modelling approach was used to fit a mediation model with the number of ACEs experienced between ages 0 and 9 years old (yo), levels of the inflammatory markers interleukin‐6 and C‐reactive protein measured at 9.5 yo, and self‐harm reported at 16 yo.ResultsThe mean number of ACEs young people experienced was 1.41 (SE 0.03). Higher ACE scores were associated with an increased risk of self‐harm at 16 yo (direct effect relative risk (RR) per additional ACE 1.11, 95% CI 1.05, 1.18, p < 0.001). We did not find evidence of an indirect effect of ACEs on self‐harm via inflammation (RR 1.00, 95% CI 1.00, 1.01, p = 0.38).ConclusionsYoung people who have been exposed to ACEs are a group at high risk of self‐harm. The association between ACEs and self‐harm does not appear to be mediated by an inflammatory process in childhood, as indexed by peripheral levels of circulating inflammatory markers measured in childhood. Further research is needed to identify alternative psychological and biological mechanisms underlying this relationship.

Adverse childhood experiences and adult inflammation: Single adversity, cumulative risk and latent class approaches

Abstract Background Adverse childhood experiences (ACEs) have long been known to be related to poorer health across the life course. Previous studies typically relied on cumulative risk scores or individual adversities measured through retrospective self-reports. However, these approaches have important limitations. Cumulative risk scores assume equal weighting of adversities and the single adversity approach ignores the high probability that adversities co-occur. In contrast, latent class analysis (LCA) offers an alternative approach to operationalise ACEs that respects the clustering of adversities and may identify specific patterns of ACEs important for health outcomes. Furthermore, prospective and retrospective reports of ACEs show poor agreement. Therefore, it is important to compare findings based on prospective and retrospective measures in the same individuals. Despite an increasing number of studies applying LCA to ACEs data, no studies have yet simultaneously investigated LCA to cumulative risk and single adversity approaches in their relationships with adult inflammation. Identifying the specific ACEs or combinations of ACEs which are strongly related to inflammation is important for investigating the mechanisms involved and the planning of effective interventions. Methods Using data on 8810 members of the 1958 British birth cohort we investigated 12 ACEs – physical, psychological and sexual abuse, physical and emotional neglect, parental mental health problems, witnessing abuse, parental conflict, parental divorce, parental offending, parental substance misuse and parental death. LCA was applied to explore the clustering of prospectively and retrospectively reported ACEs separately. Associations between latent classes, cumulative risk scores and individual adversities with three inflammatory markers (C-Reactive Protein, fibrinogen and von Willebrand Factor) were tested using linear regression. Results There was co-occurrence between adversities, and particularly for retrospectively reported adversities. Three latent classes were identified in the prospective data – ‘Low ACEs’ (95.7%), ‘Household dysfunction’ (2.8%) and ‘Parental loss’ (1.5%) which were related to increased inflammation in mid-life, as were high ACE scores and individual measures of offending, death, divorce, physical neglect and family conflict. Four latent classes were identified in the retrospective data – ‘Low ACEs’, ‘Parental mental health and substance misuse’, ‘Maltreatment and conflict’ and ‘Polyadversity.’ The latter two (5.2%) were related to raised inflammation in mid-life, as was a retrospective ACE score of 4+ (8.3%) and individual measures of family conflict, psychological and physical abuse, emotional neglect and witnessing abuse. Conclusions Specific ACEs or ACE combinations might be important for chronic inflammation. LCA is an alternative approach to operationalising ACEs data but further research is needed.

Adverse Childhood Experiences and Protective Factors With School Engagement.

To determine the associations of adverse childhood experiences (ACEs) and protective familial and community factors with school performance and attitudes in children ages 6 to 17. A cross-sectional analysis of the 2011-2012 National Survey of Children's Health was performed. All data were demographically weighted and included 65 680 children ages 6 to 17. The survey identified up to 9 ACEs in each child. ACE scores were categorized as 0, 1, 2, 3, and ≥4 ACEs. Children's protective factors (PFs) included the following: safe neighborhood, supportive neighbors, 4 neighborhood amenities, well-kept neighborhood, no household smoking, ≥5 family meals per week, and a parent who can talk to the child. PFs were categorized into ≤3, 4, 5, 6, and 7 PFs. School outcomes included the following: child repeated ≥1 grade; never, rarely, or sometimes completes homework; and never, rarely, or sometimes cares about school. χ2 tests and logistic regressions assessed the relationships between ACEs and school outcomes, PFs and school outcomes, and both ACEs and PFs and school outcomes, adjusting for sex, age, race, ethnicity, and maternal education. Each negative school outcome is associated with higher ACE scores and lower PF scores. After adding PFs into the same model as ACEs, the negative outcomes are reduced. The strongest PF is a parent who can talk to the child about things that matter and share ideas. As children's ACE scores increase, their school performance and attitudes decline. Conversely, as children's PF scores increase, school outcomes improve. Pediatric providers should consider screening for both ACEs and PFs to identify risks and strengths to guide treatment, referral, and advocacy.

Client and Provider Discomfort With an Adverse Childhood Experiences Survey

Many service providers report concerns that questions about adverse events may upset clients. Studies indicate that most survey respondents answer sensitive questions without experiencing distress, although little is known about the prevalence or correlates of clients' discomfort when they are asked similar questions by direct care providers, such as home visitors. This study used data collected between 2013 and 2018 from 1,678 clients and 161 providers in a network of home visiting programs in Wisconsin. Clients and home visitors completed an adverse childhood experience questionnaire that concludes by asking about discomfort with the questions. Analyses conducted in 2018 examined overall client discomfort and associations between discomfort and the endorsement of 10 distinct adverse childhood experiences. Multilevel regressions were performed to test whether client and provider factors were associated with client discomfort. More than 80% of clients were not at all or slightly uncomfortable with the adverse childhood experience questionnaire, and 3% reported extreme discomfort. Bivariate results showed that each adverse childhood experience, except parental divorce, was associated with greater discomfort; sexual abuse was the only adverse childhood experience associated with discomfort in a multivariate analysis. Multiple client variables were linked to increased discomfort, including higher adverse childhood experience scores (b=0.06, 95% CI=0.04, 0.08) and depression scores (b=0.01, 95% CI=0.00, 0.02). Home visitor discomfort was positively associated with client discomfort (b=0.16, 95% CI=0.01, 0.31). Results indicated that most clients in home visiting programs tolerated an adverse childhood experience questionnaire well. The findings point to clients who may be more likely to report discomfort and highlight an important association between client and provider discomfort.

Adverse Childhood Experiences and Amygdalar Reduction: High-Resolution Segmentation Reveals Associations With Subnuclei and Psychiatric Outcomes.

The aim of the present study was 2-fold: (1) to utilize improved amygdala segmentation and exploratory factor analysis to characterize the latent volumetric structure among amygdala nuclei and (2) to assess the effect of adverse childhood experiences (ACEs) on amygdalar morphometry and current psychiatric symptoms. To investigate these aims, structural (T1) MRI and self-report data were obtained from 119 emerging adults. Regression analysis showed that higher ACE scores were related to reduced volume of the right, but not the left, amygdalar segments. Further, exploratory factor analysis yielded a two-factor structure, basolateral and central-medial nuclei of the right amygdala. Stractual equation modeling analyses revealed that higher ACE scores were significantly related to a reduced volume of the right basolateral and central-medial segments. Furthermore, reduction in the right basolateral amygdala was associated with increased anxiety, depressive symptoms, and alcohol use. This association supports an indirect effect between early adversity and psychiatric problems via reduced right basolateral amygdalar volume. The high-resolution segmentation results reveal a latent structure among amygdalar nuclei, which is consistent with prior work conducted in nonhuman mammals. These findings extend previous reports linking early adversity, right amygdala volume, and psychopathology.

Adverse childhood experiences and the onset of chronic disease in young adulthood

This study examined the association of adverse childhood experiences (ACEs) with early-onset chronic conditions.We analyzed data from the 2011–2012 Behavioral Risk Factor Surveillance System (BRFSS), which included 86,968 respondents representing a nine-state adult population of 32 million. ACE questions included physical, emotional, and sexual abuse; substance use, mental illness or incarceration of a household member; domestic violence, and parental separation. Outcomes included chronic conditions (cardiovascular disease, chronic obstructive pulmonary disease, cancer, depression, diabetes, and prediabetes); overall health status; and days of poor mental or physical health in the past month. We estimated Poisson regression models of the likelihood of chronic conditions and poor health status comparing adults reporting ≥4 ACEs to respondents with no ACEs within three age strata: 18–34, 35–54 and ≥55 years.The prevalence of ≥4 ACEs was highest among youngest respondents (19%). There was a dose-response gradient between ACE scores and outcomes except for cancer in older adults. Among younger respondents, those reporting ≥4 ACEs had two to four times the risk for each chronic condition and poor health status compared to respondents reporting no ACEs. With few exceptions (depression, poor mental and physical health in the past month), incidence rate ratios were highest in young adults and successively decreased among older adults.This study is among the first to analyze patterns of association between ACEs and adult health disaggregated by age. Young adults with high ACE scores are at increased risk of early-onset chronic disease. Trauma-informed care and ACEs prevention are crucial public health priorities.

124. Adverse Childhood Experiences, Body Mass Index And Body Image In Adolescents: Are They Interrelated?

Adverse childhood experiences (ACEs) are clearly associated with increased rates of obesity later in life. Many adolescents with BMIs >85% exhibit unhealthy weight control behaviors, and body image (BI) disturbances may mediate these behaviors. However, the association between ACEs, BMI, and BI remains unexamined. Therefore, we have conducted a pilot study to examine, among preadolescents at high risk for multiple ACEs: 1) the prevalence of ACEs, BI, and BMI, and 2) the associations between number of ACEs and both BI scores and BMI percentiles. The study was conducted at a middle school in Rochester NY with a large proportion of minority and low-income students. All 7-8th graders were screened in 9/2017. ACEs were assessed using the ACE-Q (Center for Youth Wellness), an adolescent focused version of the original ACE screener. High ACEs were categorized as >3. BI was measured with the SATAQ, using a version that was validated on middle school students. Scores range from 14-70, with higher scores representing higher disturbance (or poor body esteem) in BI. A previous study of BI of white middle-class adolescents showed a mean SATAQ score of about 30 +/- 10. BMI was measured by percentile ranking, as recommended for preadolescents. We used descriptive statistics to analyze means (SD), frequencies and/or percentiles of ACEs, BI, and BMI. Bivariate analysis examined the relationship between high ACEs and BI scores and BMI percentiles. Students who assented to participate (N=151) were 62% Black or Hispanic; genders were balanced. The prevalence of ACEs in these youth was very high: 48% had >3 ACEs. In this sample, 47% had a BMI that was at the >85th percentile (overweight), and 25.5% were at the >95th percentile (obese). The mean BI score was 34.44 +/- 14.28. Thus in our sample, both BMI and BI scores were somewhat higher than previous reports for low SES youth. However, we found no significant relation between high ACEs and BI score (p=.321) or BMI percentile (p= .176). In this relatively new area of investigation, we found no associations between ACEs and BI or ACEs and BMI, unlike three previous studies. If a study with a larger sample confirms our results, our findings suggest that the preadolescent period might be optimal for interventions to prevent obesity, since ACEs and BMI, and also BMI and BI, are known to be associated in post-pubertal adolescents and in adults. The next phase of this study will evaluate the effects of a resilience intervention on pre/post BI scores in preadolescents with high ACE scores. If these results are positive, parallel studies in adolescents after puberty would be warranted.

What Doesn’t Kill You

The purpose of this exploratory study was to examine the relationship between adverse childhood experiences (ACEs) and resilience in a sample (n=139) of Masters of Social Work (MSW) students. Perceived stress, religious faith, experiential avoidance, and mindfulness were also examined as correlates of resilience. Resilience scores for the MSW students were comparable to general population and college student norms, but ACEs and perceived stress scores were higher. Despite a broad literature supporting associations of high ACE scores with varied measures of physical and psychological problems, this study paradoxically showed a positive relationship between higher ACE scores and resilience. Regression analysis indicated a model including age, ACE scores, experiential avoidance, religious faith, and perceived stress explained 39.2% of the variance in resilience scores. Prior adverse childhood experiences and stronger religious faith are associated with increased resilience, while experiential avoidance and perceived stress are associated with lower resilience. This study provides further evidence that many students come to social work education with substantial trauma histories and experience considerable stress during their studies. Results suggest that social work educators should acknowledge risks associated with avoidant coping, and provide learning experiences aimed at developing students’ capacities for increased awareness and acceptance of challenging experiences—their own and others.

Adverse Childhood Experiences Scores: When Social Work Students and Trauma Mix

This study compares the presence of Adverse Childhood Experiences (ACE) scores among social work students with other majors and predicts the likelihood of majoring in social work. Results from a Midwestern, 4-year university indicate that on average, social work students (n=81) are more likely to have higher ACE scores in all assessed items compared to students of other university majors (n=269). Findings from the logistic regression analyses suggest that students who report at least one category of adversity were more likely to major in social work compared to other university majors. Using the person-in-environment perspective lens, these findings may account for gravitation of some students toward social work as a major. Resulting implications to baccalaureate social work programs concerning curriculum, trauma awareness, and resiliency training of students are discussed.

Associations of adverse childhood experiences and social support with self-injurious behaviour and suicidality in adolescents.

There is little investigation on the interaction effects of adverse childhood experiences (ACEs) and social support on non-suicidal self-injury (NSSI), suicidal ideation and suicide attempt in community adolescent populations, or gender differences in these effects.AimsTo examine the individual and interaction effects of ACEs and social support on NSSI, suicidal ideation and suicide attempt in adolescents, and explore gender differences. A school-based health survey was conducted in three provinces in China between 2013-2014. A total of 14 820 students aged 10-20 years completed standard questionnaires, to record details of ACEs, social support, NSSI, suicidal ideation and suicide attempt. Of included participants, 89.4% reported one or more category of ACEs. The 12-month prevalence of NSSI, suicidal ideation and suicide attempt was 26.1%, 17.5% and 4.4%, respectively; all were significantly associated with increased ACEs and lower social support. The multiple adjusted odds ratio of NSSI in low versus high social support was 2.27 (95% CI 1.85-2.67) for girls and 1.81 (95% CI 1.53-2.14) for boys, and their ratio (Ratio of two odds ratios, ROR) was 1.25 (P = 0.037). Girls with high ACEs scores (5-6) and moderate or low social support also had a higher risk of suicide attempt than boys (RORs: 2.34, 1.84 and 2.02, respectively; all P &lt; 0.05). ACEs and low social support are associated with increased risk of NSSI and suicidality in Chinese adolescents. Strategies to improve social support, particularly among female adolescents with a high number of ACEs, should be an integral component of targeted mental health interventions.Declaration of interestNone.

Adverse Childhood Experiences and Justice-Involved Youth: The Effect of Trauma and Programming on Different Recidivistic Outcomes

Studies have demonstrated that adverse childhood experiences (ACEs) are prevalent in justice-involved youth and related to recidivism. However, the effect of programming on reducing reoffending for youth with a trauma history is not well researched. This study aims to examine the prevalence of ACEs across different subsets of justice-involved youth, as well as the impact of family-based programming and aggression replacement training (ART) for youth exposed to ACEs. Presence of ACEs among 50,862 in Washington State is examined via multiple statistical tests. Results indicate that ACEs are prevalent in this sample, with higher ACE scores being associated with a greater risk of reoffending for different types of recidivism. Both family-based programming and ART had an impact on recidivism for males, while only completion of ART resulted in a decreased odds of reoffending for females. However, an intervention between programming and ACEs was nonsignificant, indicating that these particular interventions are not more beneficial for youth exposed to trauma than they are for the general justice-involved youth population. Findings outline the need to give ACEs serious consideration in the juvenile justice system, as these trauma experiences can inform case management and programming.

Factors associated with psychological distress among members of HIV discordant couples in western Kenya: the role of adverse childhood experiences

# Background The relationship between measures of psychological distress and factors such as adverse childhood experiences (ACE) and HIV infection have not been well studied among members of HIV discordant couples living in Kenya. # Methods A structured questionnaire, which included the non-specific psychological distress Kessler 6 (NPD K6) scale, was administered to members of HIV discordant couples using a computer-assisted personal interview in two Kenyan communities. # Results Among the 202 participants who completed the survey (52% women and 48% men), the median NPD K6 score was equal for men and women (median=4; maximum=24). Participants did not report high levels of distress. For women, factors associated with a higher or more distressed NPD K6 score were a higher ACE score, religious affiliation, and perception of not being treated with respect by family members and partners. For men, factors associated with a higher NPD K6 score were HIV-positive status and higher ACE score. # Conclusions It is important to assess NPD and ACE in members of discordant couples, and if needed, assist them in identifying psychological counselling and support activities. By being better equipped to deal with the stressors associated with not only HIV, but also the discrimination and stigma associated with the disease, members of discordant couples may be more inclined to consider the importance of treatment and prevention.

Adverse childhood experience and rheumatic diseases.

It has been suggested that the adaptive stress response may be disrupted by life adverse events such as childhood maltreatment. To investigate if the number of adverse childhood experiences (ACEs) increases susceptibility to systemic lupus erythematosus (SLE), spondyloarthritis (SpA), scleroderma (SSc), and rheumatoid arthritis (RA), we interviewed 315 patients with rheumatic disease (100 SLE; 40 SSc; 60 SpA; 115 RA) and 272 controls, using questions of the ACEs study questionnaire validated to ask about experiences of childhood abuse, negligence, domestic violence, and household dysfunctions. The questionnaire score ranges from zero (best result) to 8 (worst scenario). Patients and controls did not differ regarding the median number of ACEs (3 in both groups, patient IQR = 2.5-5 vs. control IQR = 2-5, p = 0.45). Among the patients, 63.8% (201/315) presented ACE score ≥ 3, compared with 59.9% (163/272) of the controls (p = 0.31). The proportion of patients with at least 3 ACEs did also not differ among those with different rheumatic diseases. Specifically, 64% (64/100) of those with SLE, 60% (24/40) of those with SSc, 60% (36/60) of those with SpA, and 66.9% (77/115) of those with RA reported at least 3 ACEs. There was also no difference between the distribution of ACE scores and number of individuals with ACEs ≥ 3 between patients with different rheumatic diseases and controls. Nevertheless, there was a trend for association between higher ACE score and susceptibility to RA (p = 0.06). In this setting, the occurrence of ACEs was not associated with susceptibility to rheumatic diseases in adulthood.

2381 Childhood adversity, attachment style, and home visiting engagement

OBJECTIVES/SPECIFIC AIMS: This case-control study aims to determine the relationships among childhood adversity, attachment style, and the likelihood of accepting or declining a referral for HV. The study will serve as a pilot to inform the power analysis of a subsequently proposed full-scale study. METHODS/STUDY POPULATION: Using a case-control study design, 25 women who decline HV referral (cases) will be compared with 25 women who accept HV referral (controls) on their exposure to childhood adversity and attachment style. Women who are eligible for the study are English-speaking mothers who have been offered HV services by Health Care Access Maryland. Surveys are administered in-person, either in the participant’s home or at another location (e.g., public library), based on participant preference. The dependent variable is participant’s verbal response to the HV referral (accept/decline). The independent variable, childhood adversity, will be measured using the Philadelphia Urban Adverse Childhood Experiences (ACEs) Survey and the Attachment Style Questionnaire (ASQ). Control variables include demographics (i.e., age, race, education, employment, housing, marital status), obstetric history (i.e., previous preterm birth, miscarriage, fetal death, infant death, abortion), and current psychosocial risk factors (i.e., history of substance use, intimate partner violence, depression). Descriptive comparisons will be done for the independent and control variables in controls versus cases. Bivariate analysis will examine associations between the odds of being a case and ACE score and ASQ score. Multivariate logistic regression models will be used to examine the relationship between ACE total and ASQ score; exposure to ACE in cases versus controls; and the odds of an avoidant and anxious attachment styles in cases versus controls. RESULTS/ANTICIPATED RESULTS: We hypothesize that (a) higher ACE scores will be positively associated with a higher level of avoidant attachment; (b) higher ACE scores will be positively associated with declining a HV referral; and (c) higher levels of avoidant attachment will be associated with declining a HV referral. DISCUSSION/SIGNIFICANCE OF IMPACT: Racial inequities in birth outcomes are pervasive and unjust. Non-Hispanic Black women experience births that result in infant mortality, fetal mortality, preterm birth, and low birth weight babies at more than double the rate of non-Hispanic White women in Baltimore and nationally. Prenatal and early childhood home visiting programs have been found to decrease maternal smoking and hypertensive disorder which are associated with PTB, reduce closely spaced births which is associated with fetal and infant death, and improve women’s long-term economic self-sufficiency, child health and social outcomes. However, as community-based programs, these services are not reaching the majority of eligible women in low-income urban settings—women who are also disproportionately burdened with poor pregnancy-related health outcomes. Considering the potential to improve outcomes, the importance of eliminating health disparities, and the national and local investment in HV services, it is vital to understand why some women are not enrolling in prenatal HV programs. The findings from this and subsequent studies will inform the translation of evidence-based HV program outreach efforts for women with complex social history. It will inform the design of enhanced outreach and engagement efforts of HV programs to more reliably engage women.

Poverty, Stress, and Academic Performance: ACE Scores and the WSCC Model in an Urban District

BACKGROUND: Students living in poverty experience more traumatic stressors, which we measure using the Adverse Childhood Experiences (ACE) Scale. Health researchers continually find strong relationships between ACE scores and negative health outcomes. METHODS: Using data from the Youth Risk Behavior Survey (YRBS), we examine whether ACE scores also predict negative academic outcomes in a sample of almost 6,000 students from Buffalo Public Schools. We use regression to examine the relationship between ACE scores and reported grades. RESULTS: Students with higher ACE scores in our data exhibit more behaviors correlated with lower performance (e.g. higher drug use and lower levels of self-belief and school attachment) and report receiving worse grades. At the school-level, though, ACE scores strongly correlate with higher graduation rates, college attendance, and test scores. Within our ACE variables, White and high-income students are more likely to report being insulted by a parent while minority and low-income students are more likely to report seeing somebody shot, stabbed, or beaten in their neighborhood (which correlates with worse school-level outcomes). CONCLUSIONS: While the ACE scale has proven remarkably adept at predicting health problems, it may not be the ideal tool to predict academic challenges – particularly those associated with urban poverty.

Adverse Childhood Experiences and Development in Emerging Adulthood

To date, no study has investigated the relation of adverse childhood experiences (ACEs) with the developmental identification of the dimensions of emerging adulthood (IDEA; e.g., identity development, experimentation). Participants ( N = 832) were recruited from Amazon’s Mechanical Turk (version: ‘2014 - 08- 15'). Basic associations between ACEs and the IDEA were conducted as well as indirect effects between ACEs and the IDEA for endorsement of traditional adult roles and current stress. ACEs were associated with reporting lower scores on the IDEA. Specifically, higher ACEs were associated with feeling less self-focused and less likely to feel this period of life is a time of experimentation and possibilities. Conversely, higher ACEs scores were associated with increased negativity/instability. Current perceived stress fully and partially mediated the effect between ACEs and IDEA Scales. As posited by Arnett, ACEs was associated with decreased IDEA scores. Current perceived stress may be a salient mechanism between ACEs and developmental dimensions of emerging adulthood.

Impact of Childhood Adversity and Out-of-Home Placement for Male Adolescents Who Have Engaged in Sexually Abusive Behavior.

Child maltreatment and household dysfunction have long been linked to delinquency, adult criminality, and sexual offending. However, the association between adverse childhood experiences (ACEs), factors related to out-of-home placement, and the onset of maladaptive behaviors has not thoroughly been explored in adolescents who have engaged in sexually abusive behavior. In the present study, we examined archival records of 120 male youths who have received treatment for sexually abusive behavior. As expected, the male adolescents in this sample have experienced higher rates of ACEs than samples of adult males in the community, adult males who committed sexual offenses, and juvenile justice-involved males as reported in the literature. Discrete-time survival analyses yielded increased risks of onset of aggression and sexually abusive behavior during early childhood and mid-to-late childhood, with significant associations between higher ACE scores and a greater number of out-of-home placements. Implications and future directions are discussed.

Exploring the Association of Maternal Adverse Childhood Experiences with Maternal Health and Child Behavior Following Intimate Partner Violence.

Adverse childhood experiences (ACEs) have been empirically linked to a host of negative health outcomes, both physical and psychosocial. Exposures to ACEs make individuals more susceptible to conditions such as cardiovascular disease, diabetes, cancers, and depression. Many of these conditions do not appear until sometime in adolescence or adulthood and have been linked to premature death. This study explores the association between the number and type of exposure to ACEs in women (mothers) who experienced intimate partner violence and health outcomes. Specifically, it explores the association between maternal ACEs and maternal perceived health and maternal mental and behavioral health. This study also explores the association between ACEs and child behavior. This analysis is part of a 7-year prospective study. A cohort of 300 mother-child pairs was assessed at baseline and every 4 months after reaching out for shelter or justice services for the very first time after being in an abusive intimate relationship. Data document individual mothers' ACE scores and show a trend at 12 months, 24 months, and is most significant at 36 months. Additionally, at 36 months, higher ACE scores were significantly associated with all child behavioral subscales (anxiety, depression, aggressive behavior, attention problems, internalizing, externalizing). The women in this study reported ACE scores consistently higher than national rates. Our data highlight the added benefit of using ACE criteria as a global prevention strategy to identify those most at risk for delayed mental and behavioral health issues and to intervene with supportive strategies and guided referrals as indicated.

Family-centered prevention ameliorates the association between adverse childhood experiences and prediabetes status in young black adults.

Individuals exposed to adverse childhood experiences (ACEs) are vulnerable to various health problems later in life. This study was designed to determine whether participation in an efficacious program to enhance supportive parenting would ameliorate the association between ACEs and prediabetes status at age 25. Rural African American parents and their 11-year-old children (N=390) participated in the Strong African American Families (SAAF) program or a control condition. Each youth at age 25 provided a total ACEs score and a blood sample from which overnight fasting glucose was assayed. Logistic regression equations were used to test the hypotheses. The logistic regression analyses revealed a significant interaction between total ACEs and random assignment to SAAF or control, OR=0.56, 95% CI [0.36, 0.88]. Follow-up analyses indicated that, for participants in the control condition, a 1-point increase in ACEs was associated with a 37.3% increase in risk of having prediabetes. ACEs were not associated with the likelihood of having prediabetes among participants in the SAAF condition. Control participants with high total ACEs scores were 3.54 times more likely to have prediabetes than were SAAF participants with similar scores. This study indicated that participation at age 11 in a randomized controlled trial designed to enhance supportive parenting ameliorated the association of ACEs with prediabetes at age 25. If substantiated, these findings may provide a strategy for preventing negative health consequences of ACEs.

Retraumatization Mediates the Effect of Adverse Childhood Experiences on Clinical Training-Related Secondary Traumatic Stress Symptoms

ABSTRACTPrevious research (Butler, Carello, & Maguin, 2016) has found that exposure to trauma-related material in graduate clinical coursework and field training can put students at risk for reactivations of feelings/memories from negative past experiences (retraumatization) and for secondary traumatic stress (STS) symptoms. The present report sought to examine the role, if any, of adverse childhood experiences (ACEs) in these outcomes. Using the Butler et al. (2016) sample, we examined: (1) rates of ACEs in 195 graduate social work students, (2) whether the total number of ACEs was associated with training-related retraumatization (TRT) and/or STS symptoms, and (3) if TRT mediated the relationship between ACEs and STS symptoms. The results indicate that more than three quarters of the sample had experienced one or more ACEs before age 18 and almost one third endorsed 4 or more. The most commonly reported ACEs were household mental illness, parental separation/divorce, household alcohol/substance abuse, and emotional abuse or neglect by a parent or household member. Higher ACE scores were associated with increased likelihood of TRT experiences and STS symptoms during training. A mediation analysis confirmed that TRT mediated the effect of ACE scores on STS symptoms; this finding also provides support for the role of proximal emotional reactions in mediating the effects of distal adverse experiences on the development of trauma symptoms. In summary, despite the evident resilience of this graduate student sample, those with ACE histories were at heightened risk for training-related distress. These results underscore the need for a trauma-informed approach to clinical training.