History Of Adverse Childhood Experiences Research Articles

Early Childhood Adversity Predicts Risk of Family Caregiver Suicidal Ideation:Roles of Neuroticism and Self-Compassion.

Despite high rates of family caregiver suicidal ideation (SI), little is known about its relationship with childhood adversity. Those with a history of adverse childhood experiences (ACEs) have been shown to have higher neuroticism, lower self-compassion, and higher rates of late life mental health disorders. Caregiving for a family member with dementia may pose a particular challenge for those with ACEs. In a secondary analysis of 81 family caregivers of people living with dementia enrolled in clinical trials, we undertook a cross-sectional baseline analysis of the association between childhood adversity, measured with the ACE questionnaire, and self-reported suicidal ideation (SI). We further assessed whether the relationship between ACE and SI was mediated by neuroticism and self-compassion. 18 caregivers self-reported SI (22%). 89% of caregivers with SI reported childhood adversity (ACE > 0), versus 63% of those without SI (p=.04). The relative risk of SI was 3.6x higher in those with childhood adversity than in those without (p=.04), and for those with a specific history childhood abuse, the relative risk of SI was 3.4x higher (p=.005). Neuroticism and self-compassion mediated the relationship between ACE and SI (p<.05), with neuroticism strengthening the association and self-compassion weakening it. The association of SI with history of childhood adversity is high in family caregivers. Whereas elevated neuroticism might be one mechanism linking ACEs and SI, training self-compassion is a promising target for reducing SI. The phenotypic relationship between childhood adversity and SI in family caregivers should be further explored in larger samples, and could represent a new treatment target to improve the efficacy of therapies on caregiver emotional symptoms.

"I Just Wouldn't Like Him to go Through What I Went Through as a Kid": A Qualitative Study on the Mitigating Effects of Positive Childhood Experiences in Mothers with a History of Adverse Childhood Experiences in an Irish Population.

Adverse Childhood Experiences (ACEs) are increasingly being acknowledged as a major risk factor for instigating and sustaining cycles of trauma between mother and child. Recently, the concept of Benevolent Childhood Experiences (BCEs) has been introduced to ACEs research as a buffer against the transmission of ACEs between generations. Positive childhood experiences such as attachment to caregivers, positive peer relations and positive sense of self have been found to counteract the effects of adverse childhood experiences. The emergence of positive childhood experiences as an adaptive capacity against ACEs should be explored as a tool for psychological change, to help break the cycle of inherited trauma between generations. The present study aims to examine the lived experiences of mothers with a history of ACEs, if they consider their positive childhood experiences when parenting, and how they use these positive experiences to break the cycle of intergenerational trauma. Three women residing in a low-support service for parenting were recruited for this study. Participants were all low-income, first-time single mothers in their early thirties. A qualitative approach was designed for the study. ACEs and BCEs questionnaires were administered to participants and scores were taken into account to contextualise participant interviews. A semi-structured interview was designed in accordance with IPA guidelines. Questions were directed towards phenomenological material, focusing on participants' understanding of their experiences as mothers. Analysis of the interview data revealed three superordinate themes (replicating positive experiences, creating new positive experiences and protecting children from intergenerational trauma) related to participants' BCEs, their children's BCEs and their desire to break the cycle of intergenerational trauma. The findings of this study, namely that participants intentionally tried to create positive experiences with their own children through drawing on their own positive experiences in childhood, supports the idea that BCEs are a legitimate source of adaptive capacity for mothers with ACEs. Parenting interventions for parents with ACEs should be developed taking into account ACE and BCE scores.

A - 56 Cumulative Childhood Adversity Is Linked with Reduced Cognitive Performance during Late Childhood to Adolescence

Abstract Objective History of adverse childhood experiences (ACEs) has been linked with poorer cognitive performance in young adulthood and cognitive decline in older adults; however, few studies have examined these relationships during childhood and adolescence, which are key periods for neurocognitive development. The current study investigated the longitudinal relationships between ACEs and cognitive performance during late childhood/adolescence. Method 10,827 participants (ages = 9–15.5 years old; 48% female) were included from the Adolescent Brain Cognitive Development Study. Cumulative ACE scores were created using annual parent and child reports of youth’s exposure to ACEs from baseline (ages 9–10) to Year 4 follow-up (ages 13–15). Cognitive performance was assessed using the NIH Toolbox (completed at baseline, Year 2, and Year 4). Separate linear mixed-effects models examined associations between ACEs and cognitive performance while accounting for time, age, sex assigned at birth, caregiver education, household income, pubertal status, internalizing and externalizing symptoms, and random effects of subject and family/twin status. Additional analyses tested for interactions with time. Results Greater ACEs were associated with poorer cognitive performance on tasks measuring verbal (p’s &amp;lt; 0.001) and visual (p &amp;lt; 0.001) memory, working memory (p = 0.01), cognitive flexibility (p = 0.004), processing speed (p &amp;lt; 0.001), and language (p’s &amp;lt; 0.001), above and beyond covariates. ACEs were not associated with attention (p = 0.09). Cognitive performance improved over time; however, compared to baseline, youth with greater ACE history at Year 4 demonstrated poorer attentional performance (p = 0.008). Conclusions Findings suggest that ACEs influence cognitive performance during key neurodevelopmental periods, and future work should assess clinical utility of targeted cognitive remediation in youth with adversity history.

Exposure to Childhood Adversity and Intimate Partner Violence in a Sample of Incarcerated Women in Australia.

Women who use violence represent one of the fastest growing groups within the Australian prisoner population, including Aboriginal women who are more likely to be incarcerated than non-Aboriginal women for violent crimes. Many incarcerated women report histories of adverse childhood experiences (ACEs) and intimate partner violence. This exploratory study examines baseline data from a sample of 167 women in 3 Western Australia women's prisons enrolled in a gender-specific violent behavior program. It describes their exposure to intimate partner violence, head injury, and childhood adversities. Overall, 94% of women had experienced at least one childhood adversity (median 6), and 94% reported being a victim of physical violence by a current or former intimate partner. Aboriginal women were more likely than non-Aboriginal women to report that a family member was incarcerated as a child (p = .001). There was an association between an increased number of ACEs and head injury with a loss of consciousness (p = .008). Overall, these results present a harrowing picture of childhood exposure to adversity and violence in adulthood. Successful rehabilitation of women incarcerated for violent crimes should be cognizant of the histories of extreme violence endured by most of these women.

Exploring clinicians’ knowledge and attitudes toward the care needs of complex adult users of an Emergency Department: A descriptive mixed methods study

BackgroundAdults who frequently present (FPAs) to emergency departments (EDs) often have a history of adverse childhood experiences (ACEs) and related adult health sequelae. Implications for ED care of this group remains poorly understood. This study explored clinicians’ knowledge and attitudes toward the care needs of FPAs who have an ACEs history, providing preliminary evidence to inform further research and interventions. MethodsA purposive sample of ED clinicians completed an investigator developed mixed-methods survey. Descriptive statistics and content analysis were applied. ResultsForty-three ED clinicians completed the survey. Most perceived that ACEs were common among FPAs and influenced their ED presentations. Clinicians were more aware of the psychosocial impacts of ACEs than the risks to physical health. While most clinicians agreed that FPAs should be asked about ACEs for management planning, most never asked, describing multiple barriers to doing so. Consumer’s healthcare needs were often described as unmet by clinicians who desired additional support to provide care for this group. ConclusionsThis study highlights clinicians’ perceptions of gaps in healthcare for this patient group and introduces requirements for appropriate knowledge and resources to partner with consumers to provide patient-centred and trauma-informed health care responses.

Adverse childhood experiences as precursors to cannabis use in adulthood: A systematic review

BackgroundIndividuals with a history of Adverse Childhood Experiences (ACEs) are at risk of subsequent cannabis use. However, at present no existing systematic review explores ACEs as they relate to cannabis use. ObjectiveThe aim of this systematic review paper is to examine how adverse childhood experiences (ACEs) impact rates, patterns, and the nature of cannabis use in adulthood. MethodsGuided by the PRISMA statement, this systematic review focuses on longitudinal studies that report cannabis use in adulthood. Databases searched include PubMed and Embase. ResultsUltimately, 28 manuscripts were selected for inclusion, ranging in scope from smaller community-focused studies to nationally representative longitudinal surveys; 22 of 28 studies occurred in the United States, with sample size ranging from 303 to 15,960 participants. Instruments used to assess ACEs and cannabis use varied considerably across studies, leading to loss of consistency. Nevertheless, presence of ACEs–childhood sexual abuse in particular–was consistently associated with cannabis use later in life. Frequency and severity of ACEs was found to exert an additive cumulative effect on severity of cannabis use. ConclusionsThis systematic review lays the foundation of the current state of the science regarding ACEs and cannabis use, which can provide further insight into a better understanding of this relationship and provide potential intervention opportunities.

Prevalence and risk factors of parental mental health problems: A cross-sectional study.

An understanding of the prevalence and risk factors of parental mental health problems is important for early intervention and prevention measures and shaping services for parents and their children. However, large representative surveys of parental mental health problems and associated risk factors are lacking. The aim of this study was to estimate prevalence rates of parental mental health problems using a standardised measure of psychiatric morbidity (General Health Questionnaire; GHQ-12), in a representative sample of parents and caregivers of children and young people (2-19 years) in Northern Ireland. Further, this study explored associated risk factors of parental mental health problems. A random household survey of parents and children was conducted between June 2019 and March 2020. Parental responses on demographic, economic, familial and psychological measures were collected (N = 2815) and 22% of parents and caregivers screened positive for mental health problems. The STROBE checklist for observational research was adhered to. Multivariate logistic regression indicated that being in receipt of benefits, having poor family support, a history of adverse childhood experiences, a history of exposure to politically motivated violence (the Troubles), and a child with conduct problems and poor health were all independent risk factors of increased parental mental health problems. Findings will help to inform future commissioning and development of services and broaden understanding of the correlates of parental mental health problems.

Maternal History of Adverse Childhood Experiences and Subsequent Infant Paternal Involvement

Background and Objective Adverse childhood experiences (ACEs) are associated with unfavorable pregnancy outcomes. Fathers’ involvement during pregnancy positively impacts maternal behaviors and birth outcomes. Lack of voluntary paternity acknowledgment (PA) at birth implies potential limited paternal involvement. This study explores the association between mothers with a history of ACEs and PA status for their infants. Methods Using secondary data from the Monroe County Mothers and Babies Health Survey and logistic regression modeling, we assessed the odds of court-mandated paternity affidavit (CM-PA) associated with maternal ACEs. Univariate analyses were conducted first, with additional variables included subsequently. Results Of the 1,556 mothers with legal paternity established for their infants, 279 (18%) had a CM-PA for their infants, and 1,277 (82%) had a PA established voluntarily (vPA). Mothers of infants with CM-PA were more likely to be Black or Hispanic, had lower income and education, had higher substance use and traumatic stress, and had lower social support. A one-point increase in maternal ACE total score was associated with 14% higher odds of CM-PA (OR = 1.14; 95% CI, 1.03–1.27). Maternal experience of household dysfunction was linked to 83% higher odds of CM-PA (OR = 1.83; 95% CI, 1.23–2.71) while living with a problem drinker or drug user during childhood was associated with 70% higher odds of CM-PA (OR = 1.70; 95% CI, 1.09–2.65). Conclusion and Implications for Translation This study suggests a potential link between maternal ACEs and CM-PA, implying possible lower father involvement for the infants whose mothers experienced adverse events in childhood. To address this, future research is warranted to confirm this association and explore interventions like prenatal ACE screening in pregnancy, providing psychological support and resources for mothers to promote infant paternal involvement.

Pathways between adverse childhood experiences and viral suppression among male HIV-infected adolescents in South Africa

ABSTRACT Fewer adolescents achieve viral suppression compared to adults. One impediment may be a history of adverse childhood experiences (ACEs). To better develop targets and timeframes for intervention, this study created more robust estimates of the impact of cumulative adversity on viral suppression, tested whether the association is sensitive to the timing of adversity, and simultaneously tested several potential mechanisms. We focus on males, who have lower viral suppression than females and who may contribute to disproportionate incidence among young women. We recruited 251 male perinatally HIV-infected adolescents aged 15–19 from HIV clinics in Soweto, South Africa. Adversity was captured using the Adverse Childhood Experience – International Questionnaire (ACE-IQ). Viral load was measured using blood samples; viral suppression was defined as <20 copies/mL. Indicators of medication adherence, depression, post-traumatic stress disorder (, and substance misuse were captured. A series of pathway analysis were performed. Our sample experienced a median of 7 lifetime and 4 past-year adversities. Less than half (44%) exhibited viral suppression. Adversity demonstrated a significant association with suppression; depression mediated the association. Primary prevention of adversity among children living with HIV is paramount, as is addressing the subsequent mental and behavioral health challenges that impede viral suppression among adolescents.

Cuidándome: A trauma-informed and cultural adaptation of a chronic disease self-management program for Latina immigrant survivors with a history of adverse childhood experiences and depression or anxiety symptoms.

To develop a cultural and trauma-informed mental health self-management program for immigrant Latina survivors of adverse childhood experiences with depression or anxiety symptoms. Guided by Barrera's five-stage process for cultural adaptation, we collaborated with multiple stakeholders including clinical psychologists, community health workers, and Latina immigrant women with a history of adverse childhood experiences and depression or anxiety to transform a chronic disease self-management program to be trauma informed, culturally appropriate, and focus on self-management of depression and anxiety symptoms. Adaptations included translating program materials to Spanish, education on how early life adversity and trauma may impact mental health, virtual delivery, more frequent and shorter sessions, and addition of graphics and written prompts in workbook materials. For the facilitator's manual, culturally relevant vignettes and guidance were added to guide participants through activities and adapt sessions based on participant needs. Barrera's five-stage process was useful for adapting a program to be both trauma and culturally informed for an underserved population disproportionately affected by trauma and limited access to mental health services. The adaptation demonstrated acceptability with Latina immigrant women and the promise of utilizing unlicensed personnel and technology for increasing the reach of mental health support. (PsycInfo Database Record (c) 2024 APA, all rights reserved).

Crecimiento y desarrollo puberal en niñas adoptadas de Rusia: seguimiento de 12 años

Introduction: the objectives were to provide longitudinal data on growth and determine the age of thelarche and menarche in girls adopted from Russia. Material and methods: prospective cohort study in 24 girls from Russia adopted in Spain in the 2002-2010 period, who were followed up for 12 years. The history of adverse childhood experiences was collected by reviewing pre-adoption medical records. We recorded standardised measurements of weight, height and head circumference and the age at thelarche and menarche. The mean values were compared with reference standards. Results: Salient history: preterm birth (33.3%), low birth weight (41.7%), prenatal alcohol exposure (45.8%), abuse and neglect (54.2%). Initial evaluation: mean age, 3 years (standard deviation [SD] 1.6) years; weight z-score (z), −1.35; height z, −2.42; head circumference z −1.77. One year after adoption, there was significant catch-up growth in weight (z +0.68), height (z +0.98), and head circumference (z +0.76). Temporal trends in growth: no weight delay from age 7 years; height continued to recover until age 10 (z −0.40) and remained stable until age 15 (z −0.46); the delay was greater compared to weight at every timepoint. The mean age at onset of thelarche was 9.9 years (SD 0.8) with a height of 135.4 cm (z −0.43). The mean age at menarche was 11.9 years (SD 0.7) years, with a height of 147.6 cm (z −0.44). Conclusions: the pattern of growth and development was characterized by severe delay in linear growth and a moderate delay in weight and head circumference at the time of adoption, rapid, significant and prolonged catch-up growth, acceleration of pubertal development with early thelarche and menarche and an incomplete recovery of linear growth.

Access to and perceived unmet need for mental health services and support in a community sample of UK adolescents with and without experience of childhood adversity.

Children and adolescents with a history of adverse childhood experiences (ACEs) are more likely than their peers to develop mental health difficulties, but not enough is known about their help-seeking behaviours and preferences. We aimed to determine whether ACEs are associated with access to and perceived unmet need for mental health services and support amongst secondary school students. We used multi-level logistic regression with data from the 2020 OxWell Student Survey to assess whether ACEs were associated with (1) prior access to mental health support and (2) perceived unmet need for mental health services in a community sample of English secondary school students. We assessed ACEs as a cumulative score from the Center for Youth Wellness Adverse Childhood Experiences Questionnaire: Teen Self-Report version and accounted for current mental health difficulties as measured by the 25-item Revised Children's Anxiety and Depression Scale (RCADS). Our analysis included 2018 students across 64 schools, of whom 29.9% (598/2002) reported prior access to mental health support. Of those not reporting prior access, 34.1% (469/1377) reported a perceived unmet need for services. In the unadjusted models, cumulative ACE scores were significantly positively associated with both prior access to mental health support (odds ratio (OR)=1.36; 95% confidence interval (CI): 1.29-1.43) and perceived unmet need for mental health services (OR=1.47; 95% CI: 1.37-1.59), meaning that students who had experienced adversity had a greater chance of having previously accessed support as well as perceiving an unmet need for services. After adjusting for mental health difficulties and other sociodemographic variables, cumulative ACE scores were positively associated with prior access (adjusted OR (aOR)=1.25; 95% CI: 1.17-1.34 with a significant interaction between RCADS and ACE scores, aOR=0.88; 95% CI: 0.84-0.93) as well as perceived unmet need (aOR=1.32; 95% CI: 1.21-1.43 with a significant interaction between RCADS and ACE scores, aOR=0.85; 95% CI: 0.78-0.91). Although it is encouraging that adolescents with experience of adversity are more likely than their peers with similar levels of depression and anxiety symptoms to have accessed mental health support, there remains a concern that those who have not accessed support are more likely to perceive an as-yet unmet need for it. Mental health support must be available, accessible and acceptable to all who need it, especially for those groups that traditionally have not accessed services, including the more marginalised and vulnerable populations.

Lifetimes of Vulnerability: Childhood Adversity, Poor Adult Health, and the Criminal Legal System.

On average, incarcerated people have higher rates of poor health, mental illness, and histories of adverse childhood experiences (ACEs) than the general population. This mixed-methods analysis examines the relationship between ACEs and poor adult health among a sample of formerly incarcerated people. The quantitative analysis (N = 122) shows childhood adversity is associated with various health conditions in adulthood, although the strength of this relationship varies by the kinds of ACEs respondents encountered. The qualitative analysis of life history timelines (N = 42) reveals two pathways relating ACEs to poor health and legal system involvement: (1) violence and victimization and (2) drug use as a coping mechanism. Unaddressed mental health challenges in the aftermath of adversity emerged as an important precursor to both pathways. Prisons lack a meaningful consideration of these early life events and the social structures that result in the high rates of vulnerable people in its care.

A virtual mother-infant postpartum psychotherapy group for mothers with a history of adverse childhood experiences: open-label feasibility study

ObjectivesMothers with a history of adverse childhood experiences (ACE) are at elevated risk for postpartum mental illness and impairment in the mother-infant relationship. Interventions attending to maternal-infant interactions may improve outcomes for these parents and their children, but barriers to accessing in-person postpartum care limit uptake. We adapted a postpartum psychotherapy group for mothers with mental illness (e.g., mood, anxiety, trauma-related disorders) and ACE for live video-based delivery, and evaluated feasibility, acceptability, and preliminary efficacy in an open-label pilot study.MethodsWe recruited adults with children (6–18 months) from a perinatal psychiatry program in Toronto, Canada. The intervention was a live video-based 12-week interactive psychotherapy group focused on maternal symptoms and maternal-infant relationships. The primary outcome was feasibility, including feasibility of recruitment and retention, fidelity of the intervention, and acceptability to patients and group providers. Maternal clinical outcomes were compared pre- to post-intervention, as secondary outcomes.ResultsWe recruited 31 participants (mean age 36.5 years (SD 3.9)) into 6 groups; 93.6% (n = 29) completed post-group questionnaires, and n = 20 completed an optional post-group acceptability interview. Mean weekly group attendance was 83% (IQR 80–87); one participant (3.2%) dropped out. All group components were implemented as planned, except for dyadic exercises where facilitator observation of dyads was replaced with unobserved mother-infant exercises followed by in-group reflection. Participant acceptability was high (100% indicated the virtual group was easy to access, beneficial, and reduced barriers to care). Mean maternal depressive [Edinburgh Postnatal Depression Scale: 14.6 (SD 4.2) vs. 11.8 (SD 4.2), paired t, p = 0.005] and post-traumatic stress [Posttraumatic Stress Disorder Checklist for DSM-5: 35.5 (SD 19.0) vs. 27.1 (SD 16.7)], paired t, p = 0.01] symptoms were significantly lower post vs. pre-group. No differences were observed on mean measures of anxiety, emotion regulation or parenting stress.ConclusionsRecruitment and retention met a priori feasibility criteria. There were significant pre- to post-group reductions in maternal depressive and post-traumatic symptoms, supporting proceeding to larger-scale implementation and evaluation of the intervention, with adaptation of dyadic exercises.

ACEs and social risk factors in patients with opioid use disorder

ABSTRACT Background Individuals who experience childhood trauma may be more likely to misuse substances. The influence of social risk factors increases the frequency of opioid use. Understanding the linkages between childhood trauma, opioid use disorder, and social risk factors has the potential of improving poor health outcomes. The performance of specific role groups on office-based addition teams in documenting social risk factors in the electronic medical record had not been studied. Methods This retrospective chart review was conducted across three primary care practices at an urban academic medical center. Results The majority of our sample reported at least one social risk factor. Those patients with an advanced practice nurse and/or navigator on their team were more likely to report food insecurity and to have documentation related to involvement with the legal system. Recovery coaches were most likely to document the lack of housing stability as compared to other members of the team. Conclusions The incidence of documentation related to housing stability, food insecurity, and involvement with the legal system for patient’s engaged in an OBAT program should alert interprofessional clinicians on the team to assess for a history of adverse childhood experiences.

Adjudicated Adolescents Located on a State Sex Offender Registry Website as Adults: Common Denominators

ABSTRACT This is a landmark study, the first to use a listing on a state sex offender registry website as a predictive variable for tracking adult recidivism of male adolescents adjudicated for sex offenses, and the longest to follow a cohort of these youth after discharge from a secure residential treatment program. Upon admission, the sample (N = 145) were assessed by JSORRAT-II and MEGA ♪ , two contemporary standardized, validated risk assessment tools for assessing youth who have engaged in sexually abusive behavior. They were then followed once discharged for 17.08 years into adulthood (mean follow-up = 14.0 years, SD = 1.71). Recidivism rate was 6.2% (defined as a listing for the subject on the California Megan’s Law Sex Offender Registry Website). The study offers a baseline for future studies that use a state sex offender registry website as a predictive variable for recidivism. Shared common denominators of recidivists and non-recidivists were risk level (i.e. most were High Risk or Very High Risk on MEGA ♪ ); and having a history of adverse childhood experiences other than sexual abuse (i.e. child neglect/emotional abuse and exposure to domestic violence). A history of sexual abuse, experienced by twice as many non-recidivists as recidivists, differentiated the sample. Recidivists also had fewer protective factors than non-recidivists, as assessed by the MEGA ♪ upon admission to the facility. The mean age of recidivists was younger than non-recidivists, suggesting they may have been removed from their home at an early age, and/or had an early onset of persistent coarse sexual improprieties and/or sexually abusive behaviors that persisted into adulthood. The results highlight the importance of integrating trauma-informed interventions in treatment programs for those individuals who are sexually abusive that have a history of multiple adverse childhood experiences.

Case report: The Circle Game

The authors present a rare case of a family in which both the mother, and four decades later the son, committed second-degree murder while suffering from major mental illnesses. The mother had successfully used a mental disorder defence and it was likely that the son who had raised the defence would have qualified also. The mother has a history of adverse childhood experiences. The son had also experienced various severe childhood adversities, though there were no functional impairments, personality dysfunction, suicidality or violent crimes until the onset of treatment-resistant schizoaffective disorder around age 18. His earlier comorbidities included sport-related traumatic brain injuries, sickle cell trait, severe burns, and tardive dyskinesia. His comorbidities around the material time included occasional cannabis use and dementia pugilistica. While awaiting court ruling on criminal responsibility, additional stressors triggered significant deterioration of his schizoaffective disorder and the court found him unfit to stand trial. During rehabilitation, he was severely injured by another accused, which subsequently led to his demise. This case is the first report of intergenerational mental disorder defence and involved almost every facet of criminal forensic psychiatry, which highlights the need for further research on the association between intergenerational ACEs and intergenerational risk for criminal behaviour from a comprehensive and longitudinal perspective.

Adverse Childhood Experiences and Preventive Cervical Cancer Screening Behavior.

To examine associations between a history of adverse childhood experiences (ACEs) and receiving preventive cervical cancer screening and to investigate whether number and type of ACE exposures were predictive of cervical cancer screening uptake. Data were from 11,042 adults who completed the 2020 Texas Behavioral Risk Factor Surveillance System survey. The U.S. Preventive Services Task Force guidelines were used to indicate whether individuals had received cervical cancer screening at recommended intervals. Multiple logistic regression analysis was used to predict the likelihood of not having received the recommended preventive cancer screening by number and type of ACE exposures. Chi-square analysis was used to determine associations among demographic characteristics, cancer screening uptake, and ACE number and type. Individuals with one to three ACEs and those with six or more ACEs were statistically more likely not to have received the recommended cervical cancer screenings compared to those with zero ACEs. A history of physical ACEs was associated with 3.88 times the likelihood of not having received the recommended cervical cancer screening. To promote timely cervical cancer screening and prevent retraumatization of patients with a history of ACEs, providers should implement trauma-informed care principles in their healthcare settings.

Digital mental health interventions for anxiety and mood disorders patients: A 24-week follow-up

BackgroundDigital psychoeducational interventions have been used for self-monitoring symptoms and self-care for outpatients with affective and anxiety disorders associated with a history of adverse childhood experiences (ACEs). Outpatients with affective and anxiety disorders were recruited for digital mental health interventions (smartphone app and e-book) with treatment as usual. MethodsParticipants were evaluated at baseline and at 24-week follow-up with digital mental health interventions. Participants were assessed by questionnaire and scales (the 17-item Hamilton Depressive Rating Scale (HDRS17), Hamilton Anxiety Rating Scale (HAM-A), Adverse Childhood Questionnaire, Sheehan Disability Scale, Quality of Life, Perceived StressScale, and by anthropometric measures. Results153 participants were classified into two groups: (n = 110) participants reported having experienced at least three ACEs (<4ACEs) and (n = 43) reported having experienced four or more (≥4ACEs). At baseline, the ≥ 4ACEs group presented significantly more unstable relationship, lower quality of life, more functional impairment, more perceived stress, higher HAM-A and HDRS17 scores than < 4ACEs group. After 24 weeks, digital psychoeducational interventions improved the practice of physical activity in both groups. Digital technologies improved severity of depressive symptoms in the < 4ACEs group and decreased functional impairment in the ≥ 4ACEs group. Higher scores on HAM-A were associated with more ACEs, HDRS17 > 7 and lack of physical activities. ConclusionThese findings highlight the importance of screening for ACEs to use digital psychoeducational interventions for reducing depressive symptoms and improving physical activities in outpatients with mood and anxiety disorders.

Adverse childhood experiences in early life increase the odds of depression among adults with multiple sclerosis.

Adverse childhood experiences are demonstrated risk factors for depression, a common co-morbidity of multiple sclerosis, but are understudied among people with multiple sclerosis. Estimate the association between adverse childhood experiences and depression among 1,990 adults with multiple sclerosis. Participants were members of Kaiser Permanente Northern California from two studies between 2006 and 2021 and were diagnosed with multiple sclerosis by a neurologist. Adverse childhood experiences were assessed using two instruments, including the Behavioral Risk Factor Surveillance System. Participants self-reported ever experiencing a major depressive episode. Meta-analysis random effects models and logistic regression were used to estimate odds ratios (ORs) and 95% confidence intervals (CIs) to assess the relationship between adverse childhood experiences and a history of depression across study samples. Adverse childhood experiences were expressed as any/none, individual events, and counts. Models adjusted for sex, birth year, race, and ethnicity. Exposure to any adverse childhood experiences increased the odds of depression in people with multiple sclerosis (OR: 1.71, 95% CI: 1.21-2.42). Several individual adverse childhood experiences were also strongly associated with depression, including "significant abuse or neglect" (OR: 2.79, 95% CI: 2.11-3.68). Findings suggest that adverse childhood experiences are associated with depression among people with multiple sclerosis. Screening for depression should be done regularly, especially among people with multiple sclerosis with a history of adverse childhood experiences.