History Of Childhood Adversity Research Articles

Childhood Adversity and Children’s Academic Functioning: Roles of Parenting Stress and Neighborhood Support

Existing research has shown that adverse childhood experiences from family instability and lack of safety increase children’s risk for poor academic functioning. A recent conceptual framework, however, has emphasized the need to investigate how parenting might mediate while community context might moderate the association between childhood adversity and children’s cognitive development. In the current study, we tested the roles of parenting stress and neighborhood support in the association between cumulative childhood adversity and children’s current academic functioning. We conducted a secondary data analysis on the subsample of school-aged children (i.e., 6–17 years old; N = 65,680) from the 2011–2012 United States National Survey of Children’s Health (NSCH). The parent provided telephone survey data on six types of adversity (e.g., parent’s divorce) that the target child experienced, parenting stress, neighborhood support, as well as the child’s academic functioning. Controlling for the child’s age, gender, ethnicity, and the parent’s education level, structural equation modeling (SEM) revealed a significant moderated mediating effect: parenting stress partially mediated the association between history of childhood adversity and children’s current academic functioning (β = −1.760, p < 0.001), while neighborhood support moderated the association between parenting stress (β = 0.492, p < 0.001) and academic functioning.

970. Binge Drinking Associated with Hippocampal Structural and Functional Abnormalities in Adults with a History of Childhood Adversity

970. Binge Drinking Associated with Hippocampal Structural and Functional Abnormalities in Adults with a History of Childhood Adversity

Anxiety among adults with a history of childhood adversity: Psychological resilience moderates the indirect effect of emotion dysregulation

BackgroundAdverse childhood experiences (ACEs) have been widely identified as risk factors for increased symptoms of anxiety across the lifespan. Little is known, however, about the processes by which ACEs set the stage for increased symptoms of anxiety in adulthood. The current study evaluated whether emotion dysregulation and psychological resilience influence the association between ACEs and symptoms of anxiety. MethodsA sample of adult primary care patients (N=4006) completed self-report measures related to ACEs, symptoms of anxiety, emotion dysregulation, and psychological resilience. ResultsA moderated mediation analysis showed that emotion dysregulation mediated the association between ACEs and anxiety symptoms, and that the strength of this effect varied as a function of psychological resilience. Specifically, the influence of ACEs on emotional dysregulation was stronger among individuals with low levels of psychological resilience than among those with high levels of psychological resilience. These findings remained significant when controlling for a range of sociodemographic variables in the model. LimitationsCross-sectional designs preclude inferences about causality and self-report data may be susceptible to reporting biases. Other psychological variables that may be relevant to the current results, such as protective factors in childhood, were not assessed. ConclusionsThese results have implications for the conceptualization of ACEs, emotion dysregulation, and psychological resilience in etiological models of anxiety. They also highlight the relevance of ACEs, emotion dysregulation, and psychological resilience to the detection, treatment, and prevention of anxiety disorders.

Adverse Childhood Experiences and Disordered Gambling: Assessing the Mediating Role of Emotion Dysregulation.

Adverse childhood experiences (ACEs), such as sexual and physical abuse, have been established as risk factors for the development of disordered gambling. The underlying mechanism by which ACEs influence disordered gambling, however, remains unknown. The aims of the present research were to comprehensively investigate ten types of childhood adversity and their relationships to disordered gambling in adulthood, and to test whether emotion dysregulation mediated the relationship between ACEs and disordered gambling. A sample of community gamblers (N=414) completed self-report measures of ACEs, emotion dysregulation, and gambling severity. Results revealed a significant association between all but one type (physical abuse) of ACEs and disordered gambling. Further, the results highlighted the cumulative impact of ACEs on gambling. Specifically, individuals who experienced three or more types of ACEs were more than three times as likely to report disordered gambling as compared to individuals with no history of childhood adversity. Importantly, as hypothesized, emotion dysregulation mediated the relationship between ACEs and disordered gambling. Findings from this research describe the association between ACEs and gambling and indicate a causal link between childhood adversity and disordered gambling. Results suggest that treatment initiatives may do well to address both ACEs and emotion dysregulation in the treatment of problem gambling.

‘I’m not a barcode or case file number’: understandings of perceived social support and belonging within disadvantaged adolescents and young adults

ABSTRACTPerceived social support and a sense of belonging are thought to be protective factors against negative outcomes in adulthood that are commonly associated with childhood adversity. However, while this relationship is well established, very little is understood about how adolescents and young adults define these constructs themselves. This research aimed to examine adolescents’ and young adults’ understandings of perceived social support and sense of belonging, as well as their own understandings of their childhood experiences and current outcomes. Participants in the study were 275 adolescents and emerging adults aged between 17 and 24 (mean = 18.82, SD = 1.50), and included 177 females, 99 males, and 2 transgender participants, with 2 participants not disclosing their gender. Convenience sampling from a national group of young people accessing welfare service organisations within Australia was used. Qualitative data were obtained from 13 open-ended questions to an online survey. The study found that this group of adolescents and emerging adults with a history of childhood adversity understood social support and belonging as having someone who listened, as coming from people who surrounded them, and as impacted by their childhood experiences. We argue that support for this group of youth needs to revolve around building positive relationships in order to maximise resilience and well-being outcomes.

Childhood adversity and adult depression: The protective role of psychological resilience

Adverse childhood experiences (ACEs), such as childhood abuse, neglect, and household dysfunction, have been identified as salient risk factors for adult depression. However, not all individuals who experience ACEs go on to develop depression. The extent to which resilience- or the ability to demonstrate stable levels of functioning despite adversity- may act as a buffer against depression among individuals with a history of ACEs has not been adequately examined. To address the associations between ACEs, depression, and resilience, 4006 adult participants were recruited from primary care clinics. Participants completed self-report questionnaires including: the Adverse Childhood Experiences Questionnaire, a retrospective measure of childhood adversity; the Patient Health Questionnaire-9, a measure of the presence and severity of the major symptoms of depression; and the Connor Davidson Resilience Scale, a measure of psychological resilience. Results from regression analyses indicated that, while controlling for a range of demographic variables, both ACEs and resilience independently predicted symptoms of depression, F(9, 3040)=184.81, R2=0.354. Further, resilience moderated the association between ACEs and depression, F(10, 3039)=174.36, p<0.001, R2=0.365. Specifically, the association between ACEs and depression was stronger among individuals with low resilience relative to those with high resilience. This research provides important information regarding the relationships among ACEs, resilience, and depression. Results have the potential to inform the development of treatments aimed to reduce symptoms of depression among primary care patients with a history of childhood adversity.

Childhood Adversities Associated with Poor Adult Mental Health Outcomes in Older Homeless Adults: Results From the HOPE HOME Study

To examine whether childhood adversity is associated with depressive symptoms, suicide attempts, or psychiatric hospitalization. History of seven childhood adversities (physical neglect, verbal abuse, physical abuse, sexual abuse, parental death, parental incarceration, and child welfare system placement) was gathered through in-person interviews. Multivariate models examined associations between history of childhood adversities and moderate to severe depressive symptoms, lifetime history of suicide attempt, or lifetime history of psychiatric hospitalization. The study enrolled 350 homeless adults, aged 50 and older, in Oakland, California, using population-based sampling methods. Moderate to severe depressive symptoms were measured on a Center for Epidemiologic Studies-Depression Scale (≥22), self-reported lifetime history of suicide attempt, and self-reported lifetime history of psychiatric hospitalization. Participants with exposure to one childhood adversity had elevated odds of reporting moderate to severe depressive symptoms (adjusted odds ratio [AOR]: 2.0; 95% confidence interval [CI]: 1.1-3.7) and lifetime history of suicide attempt (AOR: 4.6; 95% CI: 1.0-21.6) when compared with those who had none; the odds of these two outcomes increased with exposure to additional childhood adversities. Participants with four or more childhood adversities had higher odds of having a lifetime history of psychiatric hospitalization (AOR: 7.1; 95% CI: 2.8-18.0); no increase with fewer adversities was found. Childhood adversities are associated with poor mental health outcomes among older homeless adults. Clinicians should collect information about childhood adversities among this high-risk population to inform risk assessment and treatment recommendations.

Characteristics of U.S. Veteran Patients with Major Depressive Disorder who require “next-step” treatments: A VAST-D report

ObjectiveFinding effective and lasting treatments for patients with Major Depressive Disorder (MDD) that fail to respond optimally to initial standard treatment is a critical public health imperative. Understanding the nature and characteristics of patients prior to initiating “next-step” treatment is an important component of identifying which specific treatments are best suited for individual patients. We describe clinical features and demographic characteristics of a sample of Veterans who enrolled in a “next-step” clinical trial after failing to achieve an optimal outcome from at least one well-delivered antidepressant trial. Methods1522 Veteran outpatients with nonpsychotic MDD completed assessments prior to being randomized to study treatment. Data is summarized and presented in terms of demographic, social, historical and clinical features and compared to a similar, non-Veteran sample. ResultsParticipants were largely male and white, with about half unmarried and half unemployed. They were moderately severely depressed, with about one-third reporting recent suicidal ideation. More than half had chronic and/or recurrent depression. General medical and psychiatric comorbidities were highly prevalent, particularly PTSD. Many had histories of childhood adversity and bereavement. Participants were impaired in multiple domains of their lives and had negative self-worth. LimitationsThese results may not be generalizable to females, and some characteristics may be specific to Veterans of US military service. There was insufficient data on age of clinical onset and depression subtypes, and three novel measures were not psychometrically validated. ConclusionsCharacterizing VAST-D participants provides important information to help clinicians understand features that may optimize “next-step” MDD treatments.

Altered Stress-Induced Regulation of Genes in Monocytes in Adults with a History of Childhood Adversity.

Exposure to serious or traumatic events early in life can lead to persistent alterations in physiological stress response systems, including enhanced cross talk between the neuroendocrine and immune system. These programming effects may be mechanistically involved in mediating the effects of adverse childhood experience on disease risk in adulthood. We investigated hormonal and genome-wide mRNA expression responses in monocytes to acute stress exposure, in a sample of healthy adults (n=30) with a history of early childhood adversity, and a control group (n=30) without trauma experience. The early adversity group showed altered hypothalamus-pituitary-adrenal axis responses to stress, evidenced by lower ACTH and cortisol responses. Analyses of gene expression patterns showed that stress-responsive transcripts were enriched for genes involved in cytokine activity, cytokine-cytokine receptor interaction, chemokine activity, and G-protein coupled receptor binding. Differences between groups in stress-induced regulation of gene transcription were observed for genes involved in steroid binding, hormone activity, and G-protein coupled receptor binding. Transcription factor binding motif analysis showed an increased activity of pro-inflammatory upstream signaling in the early adversity group. We also identified transcripts that were differentially correlated with stress-induced cortisol increases between the groups, enriched for genes involved in cytokine-cytokine receptor interaction and glutamate receptor signaling. We suggest that childhood adversity leads to persistent alterations in transcriptional control of stress-responsive pathways, which-when chronically or repeatedly activated-might predispose individuals to stress-related psychopathology.

Youth Arrested for Trading Sex Have the Highest Rates of Childhood Adversity: A Statewide Study of Juvenile Offenders.

A history of childhood adversity is associated with high-risk behaviors and criminal activity in both adolescents and adults. Furthermore, individuals with histories of child maltreatment are at higher risk for engaging in risky sexual behavior, experiencing re-victimization, and in some cases, becoming sexual offenders. The purpose of the current study was to examine the prevalence of individual and cumulative adverse childhood experiences (ACEs) reported by 102 offending youth who were arrested for trading sex and 64,227 offending youth who were arrested for various other crimes, using Florida's Positive Achievement Change Tool. Youth with violations related to sex trafficking had higher rates for each ACE as well as number of ACEs, particularly sexual abuse and physical neglect. These findings have implications for identifying adverse experiences in both maltreated and offending youth as well as tailoring services to prevent re-victimization.

Adverse Childhood Events and the Risk for New-Onset Depression and Post-Traumatic Stress Disorder Among U.S. National Guard Soldiers.

This article examines the relationship between childhood adversity and postdeployment new-onset psychopathology among a sample of U.S. National Guard personnel deployed during Operation Iraqi Freedom and Operation Enduring Freedom with no history of post-traumatic stress disorder (PTSD) or depression. We recruited a sample of 991 Ohio Army National Guard soldiers and conducted structured interviews to assess traumatic event exposure, a history of childhood adversity, and postdeployment depression, and PTSD, consistent with the Diagnostic and Statistical Manual of Mental Disorders-Fourth Edition. We assessed childhood adversity by using questions from the Childhood Adverse Events Survey. In multivariable logistic models, a history of any childhood adversity was significantly associated with new-onset depression, but not PTSD, postdeployment. This finding suggests that a history of childhood adversity is predisposing for new-onset depression, among U.S. National Guard soldiers who were deployed with no prior history of PTSD or depression. This highlights the centrality of childhood experience for the production of mental health among soldiers.

Mental Health Disorders and Treatment Seeking Among Veterans in Non-VA Facilities: Results and Implications from the Veterans' Health Study

We surveyed 700 veterans who were outpatients in a non–Veterans Affairs (VA) multihospital system. Our objective was to assess the prevalence of mental disorders and service use among these veterans. The majority were Vietnam veterans (72.0%), and male (95.9%), and 40.4% reported recently using the VA for care. The prevalence of lifetime post-traumatic stress disorder (PTSD) was 9.6%, lifetime depression 18.4%, and lifetime mental health service use 50.1%. In multivariate analyses, significant factors associated with PTSD, depression, and mental health service use were low self-esteem, use of alcohol/drugs to cope, history of childhood adversity, high combat exposure, and low psychological resilience. VA service use was associated with greater mental health service use and combat exposure. With the exception of alcohol misuse, the mental health status of veterans seen in non-VA facilities appeared to be better than reported in past studies. Because most veterans have access to both VA and non-VA services, these findings have implications for veterans and outcomes research.

Childhood adversity and depression.

aDepartment of Psychiatry, GGZ inGeest, Amsterdam, the Netherlands. *Corresponding author: Jenneke E. Wiersma, PhD, Department of Psychiatry, GGZ inGeest, A. J. Ernststraat 1187, Amsterdam, Netherlands 1081 HL, the Netherlands (j.wiersma@ggzingeest.nl). J Clin Psychiatry 2015;76(7):e906–e907 dx.doi.org/10.4088/JCP.14com09454 © Copyright 2015 Physicians Postgraduate Press, Inc. experienced emotional neglect on a regular basis. In a group of chronically depressed individuals (n = 395), this number goes up to 53%.5 Hovens et al10 state that the serious and lifelong consequences of emotional neglect on adult psychopathology have not been recognized for a long time. Most studies have focused on childhood adversities such as sexual abuse, physical abuse, and (physical) neglect. Emotional neglect is often not specifically asked for, and thus is underreported, while the studies that focus on emotional neglect show its importance, especially when it comes to chronic depression.5 Since childhood adversities, and especially those related to maladaptive family functioning, have been linked to more unfavorable clinical characteristics of depression, it is not surprising that these childhood adversities are also associated with poor treatment response for depression.3 However, it may also be the case that this group of patients needs another treatment approach.11 Research has suggested that individuals with and without a history of childhood adversity may react differently to treatment. In a large group of chronically depressed patients (N = 681), a differential response to psychotherapy (Cognitive Behavioral Analysis System of Psychotherapy) versus pharmacotherapy was found as a function of the presence of childhood adversity (sexual abuse, physical abuse, neglect, and parental loss).11 Psychotherapy was superior over pharmacotherapy for chronically depressed patients who reported childhood adversity. This suggests that there may be important differences in the etiology and pathogenesis of depression in individuals with and without a history of childhood adversity.11 Indeed, biological studies have indicated such differences.12–15 Although research on neurobiological changes in response to childhood adversity is still nascent and, as of yet, based on very mixed samples of children or adults with diverse experiences of childhood adversity, there is a growing body of evidence that childhood adversity contributes to stress-induced changes in a child’s neurobiological systems. These changes may be adaptive at first, but may become maladaptive in the long run by increasing the risk for psychopathology, such as depression.12–15 Importantly, these neurobiological changes in response to childhood adversity may not be permanent; children in foster care experienced a normalization of stress-induced cortisol responses after their foster parents underwent an attachment-based intervention.16 Studies on the interaction of genes and environment underline these findings; positive environmental influences, such as social support, can buffer genetic and environmental risk for depression and promote resilience.13,15,17 In support of this, Kaufman et al18 found that children with genetic Childhood Adversity and Depression

Childhood Adversity Interacts With Adult Stressful Events to Predict Reduced Likelihood of Smoking Cessation Among Women but Not Men

Research has documented important sex differences in associations between early stress, stress-sensitization, and psychiatric outcomes. The current study investigated whether sex differences in stress-sensitization extended to cigarette smoking cessation. Data were analyzed from the National Epidemiologic Survey on Alcohol and Related Conditions (waves 1 and 2), selecting for current daily and non-daily smokers at wave 1 (daily smokers: n=3,499 women, 3055 men; non-daily smokers: n=451 women, 501 men). Three-way interactions between sex, childhood adversity, and past year stressful life events were modeled in the prediction of smoking cessation. Among women, stressful life events were more strongly related to lower likelihood of smoking cessation for those with a history of childhood adversity than those without. This relationship was not found among men. The stress-sensitization model may be applicable to women with regards to smoking cessation, supporting further exploration of stress-sensitization as a prevention and clinical target for smoking cessation.

The Specific Role of Childhood Abuse, Parental Bonding, and Family Functioning in Female Adolescents With Borderline Personality Disorder.

This study examined a broad variety of adverse childhood experiences in a consecutive sample of female adolescent inpatients with borderline personality disorder (BPD; n = 44) compared with a clinical control (CC; n = 47) group with mixed psychiatric diagnoses. BPD was diagnosed using a structured clinical interview; different dimensions of childhood adversity were assessed using the Childhood Experiences of Care and Abuse Questionnaire, the Parental Bonding Instrument, and the Family Assessment Device. A history of childhood adversity was significantly more common in patients with BPD than in the CC group. Using a multivariate model, sexual abuse (OR = 13.8), general family functioning (OR = 8.9), and low maternal care (OR = 7.6) were specific and independent predictors of adolescent BPD. The results increase our knowledge of the specific role of different dimensions of childhood adversity in adolescent BPD. They have important implications for prevention and early intervention as they highlight the need for specific strategies for involving the family.

Anxiety and insomnia as modifiable risk factors for somatic symptoms in Chinese: a general population-based study.

This study aims at investigating the stressors that increased the risk of somatic symptoms in the general Chinese population. Chinese participants (n = 202) were recruited in a population-based household survey. Somatic symptoms were measured by the Patient Health Questionnaire-15, while potential stressors that increased the risk of somatic symptoms were measured by the Perceived Stress Scale, Hospital Anxiety and Depression Scale, Insomnia Severity Index and ENRICHD Social Support Instrument. Structured multiphase regression modeling showed that female gender (estimated coefficient = 1.47, 95 % CI .7-2.24, p < .001), history of childhood adversities (estimated coefficient = .41, 95 % CI .06-.76, p = .023), employed (estimated coefficient = .87, 95 % CI .003-1.74, p = .049), a high level of anxiety (estimated coefficient = .26, 95 % CI .17-.36, p < .001) and severe insomnia (estimated coefficient = .11, 95 % CI .04-.18, p = .003) are significant stressors for increasing the risks of somatic symptoms in the Chinese population. Physical and psychological symptoms are intertwined. It was recommended that reducing anxiety and improving sleep quality would be helpful to reduce somatic symptoms. These findings help in early identification and treatment of Chinese adults with persisting somatization.

Aggression in Schizophrenia and its Relationship to Neural Circuitry of Urgency

Aggression in Schizophrenia and its Relationship to Neural Circuitry of Urgency

Maternal separation modifies behavioural and neuroendocrine responses to stress in CCR7 deficient mice

Alterations in immune function of various humoral and cellular factors, including chemokines, secondary to early stress may play a role in the enhanced vulnerability to psychiatric conditions in those with a history of childhood adversity. C57BL/6 (WT) mice and mice deficient for the chemokine receptor type 7 (CCR7−/−) were used to determine the effects of maternal separation on a range of behaviours and the biological stress response. Unpredictable maternal separation (MS) was conducted for 3h daily from postnatal day 1 to 14, with subsequent behavioural testing at 10 weeks of age. Corticosterone was quantified in 11-week-old mice. Maternally separated (MS) CCR7−/−, but not WT mice, displayed reduced interest in social novelty compared to CCR7−/− naïve mice. Separated CCR7−/− mice also exhibited significantly lower serum corticosterone concentrations compared to non-separated mice. CCR7−/− mice spent less time in the centre during an open field test and more time in the closed arm of the elevated zero maze compared to their wild-type (WT) controls suggesting they were more anxious, however, no difference was observed between MS and control mice in either strain or test. Together these findings suggest that CCR7 is involved in mediating social behaviour and stress response following maternal separation, whereas other behaviours such as anxiety appear to be modified by CCR7 independent of maternal separation. The observed altered cell-mediated immune function possibly underlying the behavioural and neuroendocrine differences in CCR7−/− mice following maternal separation requires further investigation.

History of childhood adversity is positively associated with ventral striatal dopamine responses to amphetamine

Childhood exposure to severe or chronic trauma is an important risk factor for the later development of adult mental health problems, such as substance abuse. Even in nonclinical samples of healthy adults, persons with a history of significant childhood adversity seem to experience greater psychological distress than those without this history. Evidence from rodent studies suggests that early life stress may impair dopamine function in ways that increase risks for drug abuse. However, the degree to which these findings translate to other species remains unclear. This study was conducted to examine associations between childhood adversity and dopamine and subjective responses to amphetamine in humans. Following intake assessment, 28 healthy male and female adults, aged 18-29years, underwent two consecutive 90-min positron emission tomography studies with high specific activity [(11)C]raclopride. The first scan was preceded by intravenous saline; the second by amphetamine (AMPH 0.3mg/kg). Consistent with prior literature, findings showed positive associations between childhood trauma and current levels of perceived stress. Moreover, greater number of traumatic events and higher levels of perceived stress were each associated with higher ventral striatal dopamine responses to AMPH. Findings of mediation analyses further showed that a portion of the relationship between childhood trauma and dopamine release may be mediated by perceived stress. Overall, results are consistent with preclinical findings suggesting that early trauma may lead to enhanced sensitivity to psychostimulants and that this mechanism may underlie increased vulnerability for drug abuse.

A Characterization of Adult Victims of Sexual Violence: Results From the National Epidemiological Survey for Alcohol and Related Conditions

Sexual violence can cause acute and persistent negative psychological outcomes among children and adults in a community. Previous studies have frequently reported high prevalence of prior child and adolescent sexual abuse among adult victims of sexual violence. This raises uncertainty over the specific contribution of sexual victimization in adulthood to the adverse psychological outcomes. The present study draws on a large nationally representative sample of adults without history of childhood sexual abuse, and applies diagnostic criteria of DSM-IV, in order to investigate the risk factors and psychiatric comorbidities correlated with sexual victimization in adulthood. In a large representative sample of U.S. adults without history of childhood sexual abuse, 2.5% reported sexual victimization in adulthood. Female gender, living alone, economic disadvantage, and a history of childhood adversities and parental psychopathology were identified as risk factors. Adult sexual victimization increased the risk of developing a variety of psychiatric disorders, especially PTSD (HR = 3.43, 95% CI [2.67, 4.41]) and drug abuse (HR = 3.38, 95% CI [2.49, 4.58]). Conversely, pre-existing psychiatric psychopathology, particularly PTSD (HR = 3.99, 95% CI [2.68, 5.94]) and dysthymia (HR = 2.26, 95% CI [1.42, 3.59]), increased the likelihood of sexual victimization in adulthood. Childhood experience and adulthood sociodemographic characteristics are important in affecting the risk of being sexually victimized in adulthood. Psychiatric disorders can act as both risk factors and outcomes of adult sexual victimization.