Impact Of Adverse Childhood Experiences Research Articles

Prevalence and Impact of Adverse Childhood Experiences on Chicago Public School Students in the Youth Risk Behavior Survey.

Adverse Childhood Experiences (ACEs) can impair health and other outcomes. To obtain district-level data about the prevalence and impact of ACEs in Chicago Public Schools (CPS), we advocated for CPS to add a short ACE screener to the 2017 Youth Risk Behavior Survey (YRBS) and analyzed the results. Responses to the screener were scored zero, one, or two ACEs. Student scores for violence and victimization, substance use, sexual health risk, mental health, housing insecurity, physical health, grades, and multiple risk/high vulnerability (those students in the top 20% of affirmative responses) were correlated with ACE scores for categories and individual items. Among 1883 student respondents (response rate 73%), there were 17.8% affirmative responses for experiencing physical abuse and 19.8% for witnessing domestic violence; 20% reported at least one ACE and 8% both. A significant dose-response was found for behaviors, experiences, and sleep by ACE scores. ACEs were common among CPS high school students and associated with many negative behavior and health-related outcomes. Increased awareness of ACEs and their impact among all school personnel can inform and strengthen the development of safer, more supportive, and trauma-informed schools that help all students and families thrive.

A Delphi study to identify intervention priorities to prevent the occurrence and reduce the impact of adverse childhood experiences.

There is a lack of a systematic, coordinated approach to reducing the occurrence and impact of adverse childhood experiences. Hence, identifying feasible intervention priorities in this field will help inform policy and reformation of ongoing service delivery. The objective of this study was to identify expert consensus-driven priority interventions for reducing the occurrence and impact of adverse childhood experiences in children under 8 years of age in the Australian context. A three-round online Delphi survey was conducted to establish consensus on 34 interventions for adverse childhood experiences identified through a literature search. Six were general categories of interventions, 6 were broad intervention programmes and 22 were specific interventions. Participants were 17 health practitioners, 15 researchers, 9 policy experts, 7 educators and 3 consumer advocates with expertise in adverse childhood experiences or child mental health. Consensus was defined as an intervention being rated as 'very high priority' or 'high priority' according to its importance and feasibility by ⩾75% of all experts. Seven of the 34 interventions were endorsed as priority interventions for adverse childhood experiences. These included four general categories of intervention: community-wide interventions, parenting programmes, home-visiting programmes and psychological interventions. Two broad intervention programmes were also endorsed: school-based anti-bullying interventions and psychological therapies for children exposed to trauma. Positive Parenting Program was the only specific intervention that achieved consensus. This is the first study to identify stakeholder perspectives on intervention priorities to prevent the occurrence and impact of adverse childhood experiences. Prioritisation of effective, feasible and implementable intervention programmes is an important step towards better integration and coordination of ongoing service delivery to effectively prevent and respond to adverse childhood experiences.

Impact of Adverse Childhood Experiences on the Mother-Infant Social-Emotional Well-Being in Low- and Middle-Income Countries

The “Ghosts in the Nursery” metaphor demonstrates how the impact of parental adverse childhood experiences (ACEs) persist across the lifespan and confers risk to the psychosocial development of subsequent generations. Mothers in low- and middle-income countries (LMICs) suffer increased vulnerability to ACEs because of complex biological, psychological, economic, social, and environmental risk factors, which, in turn, prevent children from attaining their developmental potential. This article reviews the evidence of maternal ACEs' impact on child social and emotional developmental outcomes in LMICs as well as possible psychological and neurobiological mechanisms for intergenerational transmission of ACEs. Clinical implications of elucidating the association between ACEs and subsequent sequelae on child development highlights the need to screen for maternal ACEs in prenatal and pediatric settings. A main emphasis of this article is to promote child mental health prevention intervention by focusing on addressing maternal ACEs and by helping caregivers to be “Angels in the Nursery.” Angels in the Nursery are characterized by care-receiving experiences that provide the child with a core sense of self-worth and security that can be drawn upon when the child becomes a parent to interrupt the cycle of maltreatment and thus effectively promote child mental health. [ Psychiatr Ann . 2021;51(7):316–321.]

A systematic review of adverse childhood experiences (ACEs) with people with intellectual disabilities: an unsafe gap in the literature

PurposeThis paper aims to systematically review the available evidence that explores adverse childhood experiences (ACEs) in people with intellectual disabilities (PwID). It is important to systematically review this literature as, to date, there is little known about the number of studies in this area, despite the World Health Organization declaring ACE prevention and support as a global public health priority.Design/methodology/approachPublished studies were identified from electronic database searches. Key journals and reference lists were also hand searched.FindingsTwo studies met the inclusion criteria and the prevalence and frequency of ACEs experienced by participants of these studies analysed. Overall, due to the small number of studies meeting the inclusion criteria, it is difficult to establish any meaningful conclusions.Originality/valueThis appears to be the first systematic review to try and identify a research base looking at the prevalence of ACEs within a PwID population. Findings suggest that this is a highly neglected area of research, and the authors hope to have identified that further evidence is required to draw clearer conclusions about the impact of ACEs on PwID.

Adverse childhood experiences contribute to race/ethnic differences in post-secondary academic performance among college students

Objective This study explores how adverse childhood experiences (ACEs) relate to race/ethnicity and academic achievement among a sample of college students. Participants Participants were students attending a large public university in the Southwest (n = 404). Methods: Online surveys captured ACE scores, demographics, and self-reported GPA. Results Students of Color had higher ACE scores and lower GPAs than White students. Regression analyses also revealed that an ACE score of 4 or higher is associated with lower GPAs, but only for Students of Color (Black and Hispanic students), not for White students. Conclusions There are race/ethnic differences in the incidence and impact of adverse childhood experiences on post-secondary academic achievement. Thus, it is important for colleges and universities to create a trauma-informed campus culture and holistic mental health support system, particularly for Students of Color, who may not have had access to high quality care before attending college.

Preliminary findings for adverse childhood experiences and associations with negative physical and mental health and victimization in transmasculine adults

IntroductionStudies highlight the impact of adverse childhood experiences (ACEs) on risk for negative health outcomes in adulthood, including cancer, cardiovascular disease, substance use, and mental health. Lesbian, gay, bisexual, and transgender (LGBT) people report higher rates of ACEs than non-LGBT people, with transgender people at greatest risk. ObjectiveThis study aims to comprehensively assess the prevalence of ACEs and association with health outcomes among transmasculine individuals. Participants and settingA sample of 131 transmasculine individuals enrolled in a clinical trial on preventive cervical cancer screening between March 2015 and September 2016 in the United States were surveyed about ACEs and health outcomes. MethodsPearson's chi-squared tests and logistic regression models were used to examine associations between self-reported ACEs prior to age 18 and the risk of various negative health outcomes in adulthood. ACEs were categorized as 0–1 ACEs, 2–3 ACEs, and 4+ ACEs. ResultsOver 90% of the sample (120/131) reported at least 1 ACE; 45% (59/131) reported 4+ ACEs. Report of 4 or more ACEs increased risk for negative health outcomes and risk factors compared to 0–1 ACEs, including: depression (AOR = 5.3, 95%CI = 1.7, 16.2), suicidality (AOR = 5.2, 95%CI = 1.4, 18.8), post-traumatic stress disorder (AOR = 6.0, 95%CI (1.6, 22.8)), intimate partner violence (AOR = 5.3, 95%CI = 1.4, 18.8), and obesity (AOR = 8.2, 95%CI = 1.8, 37.2). Report of 2–3 ACEs was also significantly associated with obesity (AOR = 5.9, 95%CI = 1.3, 26.2). ConclusionsACEs are highly prevalent in this sample, and more attention is needed for research and intervention. This exploratory study is the first to comprehensively highlight patterns of physical and mental health risk and victimization associated with report of ACEs among transmasculine individuals. Trauma-informed screening and intervention efforts tailored to the unique needs of this population are needed to provide appropriate and effective care. Clinicians should consider routinely screening for ACEs among transmasculine youth and engage in prevention strategies to reduce health disparities. Further research is warranted to validate these findings among larger, more representative samples to better reflect the diversity of experiences and identities of transmasculine individuals and produce more reliable findings.

Stress in the onset and aggravation of learning disabilities

Despite substantial grounds for such research, the role of chronic exposure to stressors in the onset and aggravation of learning disabilities (LDs) is largely unexplored. In this review, we first consider the hormonal, (epi)genetic, and neurobiological mechanisms that might underlie the impact of adverse childhood experiences, a form of chronic stressors, on the onset of LDs. We then found that stress factors combined with feelings of inferiority, low self-esteem, and peer victimization could potentially further aggravate academic failures in children with LDs. Since effective evidence-based interventions for reducing chronic stress in children with LDs could improve their academic performance, consideration of the role of exposure to stressors in children with LDs has both theoretical and practical importance, especially when delivered in combination with academic interventions.

Frequency and impact of childhood sexual and physical abuse on people using IAPT services.

This study explored the prevalence of childhood sexual/physical abuse (CSA/CPA) as identified by practitioners in Improving Access to Psychological Therapies (IAPT) services and clarified differences in clients' characteristics with and without a history of CSA/CPA. A retrospective analysis of a large dataset comprised of IAPT routine data and data from a local service evaluation reporting on clients' presenting problems. 14% of IAPT clients (n=1,315) were identified with a record of CSA/CPA. CSA/CPA history was associated with longer duration and earlier age of onset of condition(s), greater number of presenting problems and post-traumatic stress disorder co-occurrence, higher intensity treatment delivery, and lower recovery rates. CSA/CPA history appears as an important feature in a sizable minority of IAPT clients; further work is required to meet clients' trauma-related needs. A sizable minority of IAPT clients (14%) present with a history of CSA/CPA as recorded in clinical notes. CSA/CPA history is associated with more complex and enduring presentations in IAPT clients. The reported CSA/CPA frequency is likely to be underestimates of the actual prevalence and impact of adverse childhood experiences in IAPT clients. Trauma-informed inquiry and trauma-specific screening tools would help practitioners to meet clients' trauma-related needs.

The prospective impact of adverse childhood experiences on justice-involved youth's psychiatric symptoms and substance use.

Justice-involved youth report high rates of adverse childhood experiences (ACEs; abuse, neglect, household dysfunction) and are at high risk for elevated behavioral health needs (i.e., substance use, psychiatric symptoms). Research with broad samples of adolescents shows ACEs predict behavioral health outcomes, yet most research on the impact of ACEs among justice-involved youth focuses on recidivism. The present study addresses this gap by examining the prospective association between ACEs and psychiatric symptoms, substance use, and substance-related problems (i.e., consequences of use) among first-time justice-involved youth. First-time justice-involved youth (n = 271; 54.3% male; M age = 14.5 years; 43.5% Latinx; non-Latinx: 34.2% White, 8.6% Black, 7.1% Other, 6.7% Multiracial) and their caregivers were assessed at youth's first court contact and 4- and 12-month follow-ups. Youth and caregivers reported youth's exposure to ACEs through a series of instruments at baseline and 4-months (e.g., Childhood Trauma Questionnaire Short-Form; Traumatic Life Events Inventory). Primary outcomes included youth alcohol and cannabis use (Adolescent Risk Behavior Assessment), consequences of use (Brief Young Adult Alcohol Consequences Questionnaire; Brief Marijuana Consequences Scale), and psychiatric symptoms (Behavior Assessment System for Children; National Stressful Events Survey PTSD Short Scale). Youth were exposed to three ACEs, on average, prior to first justice contact (M = 3). Exposure to more ACEs, particularly abuse, predicted substance use and psychiatric outcomes. Gender differences emerged for cannabis use and internalizing symptoms. Implications for trauma-responsive juvenile justice reform are discussed, including screening for ACEs and their sequelae at first court contact and considering the role of masculine norms. (PsycInfo Database Record (c) 2021 APA, all rights reserved).

Impact of Adverse Childhood Experiences in a Student-Run Free Clinic Population

Impact of Adverse Childhood Experiences in a Student-Run Free Clinic Population

The Intergenerational Impact of Adverse Childhood Experiences on Hispanic Families: The Mediational Roles of Parental Depression and Parent–Adolescent Communication

Parental exposure to adverse childhood experiences (ACEs) has been documented as a strong risk factor for subsequent externalizing behaviors in their youth. Although studies have investigated ACEs and their intergenerational association with youth externalizing behaviors, this association has not been investigated in Hispanic families. Additionally, substantial gaps in the literature exist explaining the mechanisms by which this association occurs. The purpose of this study was to examine whether parent-adolescent communication and parental depressive symptomatology explain the relationship between parent's ACE score and adolescent externalizing behaviors. This secondary data analysis utilized baseline data from an ongoing randomized controlled trial evaluating the relative effectiveness of an online parenting intervention for Hispanic adolescents. The sample consisted of 456 parents and their adolescents between the ages of 12-16. Using path modeling, parental depressive symptomatology and parent-adolescent communication were simultaneously examined as mechanisms that may explain the intergenerational relationship between parental exposure to ACEs and externalizing behaviors in Hispanic youth. Parental depressive symptomatology and parent-adolescent communication both significantly mediated the association between parental exposure to ACEs and adolescent externalizing behaviors. Understanding the mechanisms explaining the intergenerational association between parental exposure to ACEs and adolescent externalizing behaviors may aid future research examining problematic behaviors in Hispanic youth.

"Is there anything else you would like me to know?": Applying a trauma-informed approach to the administration of the adverse childhood experiencesquestionnaire.

Nearly ubiquitous agreement exists regarding the potentially negative impact of adverse childhood experiences (ACEs) on health and well-being across the lifespan. This has propelled a movement across the nation for consistent screening of ACEs. Despite agreement regarding the consequences of ACEs, little research related specifically to the administration of the ACE questionnaire exists. Using data from a mixed-methods study of first-time mothers as means of illustration, this paper examines shortcomings of the ACE questionnaire. Participant responses revealed ambiguity with item structure, limited breadth of included events, and failure to capture the gravity of the experience. These shortcomings underscore inadequacies of the measure in accurately understanding individuals' lived experiences and call for the application of trauma-informed (TI) values, both in its content and administration. We apply the main tenets of a TI framework to the ACE questionnaire and make recommendations for its administration, translating theoretical underpinnings of a TI approach into action.

Opening the proverbial 'can of worms' on trauma-specific treatment in prison: The association of adverse childhood experiences to treatment outcomes.

A large body of research has shown that incarcerated populations have a high prevalence of adverse childhood experiences (ACEs), increasing their risk for associated mental health problems and violent and aggressive behaviours. Emerging research on treatment for trauma survivors shows evidence that incarcerated women and men, with the most complex histories of trauma and abuse, can be responsive to trauma-specific treatment. Current research assessing two gender-responsive and trauma-specific brief interventions (e.g., Healing Trauma for Women and Exploring Trauma for Men) have demonstrated feasibility, consistency and efficacy among incarcerated populations. The current study uses secondary data analysis to explore the relationship between cumulative ACEs and the impact of the Healing Trauma and Exploring Trauma on participant's (682 women and 624 men) mental health, aggression and anger outcomes. The mixed-method regression results show that the impact of ACEs on treatment outcomes is strong and cumulative (i.e., greater exposure to childhood traumatic events increased the likelihood of participant programme gain on all the mental health and aggression outcomes, ranging from .13 to 1.2 for women and .15 to .77 for the men). The lowest significant coefficient for both women and men was for verbal anger and the largest was for current trauma symptoms. The association of ACEs on anger outcomes varied between women and men (revealing more association among the men). The findings show a strong positive impact for the trauma-specific brief interventions, particularly for those with the highest levels of trauma, whom otherwise might not have been ineligible for any programme participation.

Association of adverse childhood experiences with diabetes in adulthood: results of a cross-sectional epidemiological survey in Singapore

ObjectivesSeveral studies have linked diabetes mellitus to adverse childhood experiences (ACEs). While a number of studies have examined the association between ACEs and diabetes in Western populations, few have done...

The impact of adverse childhood experiences on adolescent health risk indicators in a community sample.

Despite growing awareness of the high prevalence of adverse childhood experiences (ACEs) in community samples of adolescents, little work has examined the impact of ACEs on adolescence and well-being during this critical period of development. Much research has focused on retrospective reports of ACEs by adults and adult physical and mental health, finding that ACEs contribute to a range of diseases and mental health disorders in adulthood. This study examined differences in self-reported mental health, nonsuicidal self-injury, suicidality, violence, and substance use between adolescents without self-reported history of ACEs, youth with one self-reported ACE, and youth with self-reported multiple (2 or more) ACEs. The sample included 1,532 adolescents who completed the Youth Risk Behavior Surveillance Survey in their local high schools. By local consensus, this national survey was augmented with questions exploring prevalence of 11 commonly identified ACEs. After controlling for age, gender, and race, youth with multiple ACEs reported 3 to 15 times the odds of a range of negative health experiences. Findings indicate a serious burden of ACEs on adolescent social emotional well-being. This study did not include youth in out of school placements or who were not present the day the survey was given, and thus represent youth who may benefit from universal prevention and intervention programs. Universal screening of ACEs and health-related outcomes suggests that reporting multiple ACEs is strongly related to a wide range of mental health, violence, and substance use histories. (PsycInfo Database Record (c) 2021 APA, all rights reserved).

Community Perceptions and Interventions for the Long-term Impact of Adverse Childhood Experiences in Kisii, Kenya: A Qualitative Study

Community Perceptions and Interventions for the Long-term Impact of Adverse Childhood Experiences in Kisii, Kenya: A Qualitative Study

아동기 부정적 생애경험이 성인기 우울장애 및 자살생각에 미치는 영향

본 연구는 아동기 부정적 생애경험 의 누진적인 빈도를 확인하고 이것이 (Adverse Childhood Experiences, ACEs) , 성인기 우울장애 및 자살생각에 영향을 미치는지 살펴보았다. 전국 만 18세 이상 성인 남녀를 대상으로 성균관대학교 서베이리서치센터에서 조사한 ‘2012년 한국종합사회조사(Korean General Social Survey, KGSS)’ 자료를 사용하였다. 1,033명을 대상으로 한 연구결과, 10개의 아동기 부정적 생애경험 중 4개 이상의 부정적 경험에 노출된 경우가 18.6%에 해당되었다. 우울장애의 경우, 아동기 부정적 생애경험 점수가 0인 경우를 비교 집단으로 했을 때, 나이, 성별, 월평균 가구소득, 고졸여부를 통제하고 아동기 부정적 생애경험 점수가 4 혹은 그 이상일 경우 성인기에 우울장애를 경험할 가능성이 6.11배 높았다. 또한, 자살생각의 경우, 아동기 부정적 생애경험 점수가 0인 경우를 비교집단으로 하고, 통제변수를 통제했을 때, 아동기 부정적 생애경험 점수가 4 혹은 그 이상일 경우 성인기 자살생각을 할 가능성이 4.14배 높았다. 이러한 결과에 따라 정신건강 영역 종사자에 대한 아동기 부정적 생애경험의 영향력을 알리고, 실천의 효과성을 높이기 위한 다각적 노력이 요구된다.

The Impact of Adverse Childhood Experiences (ACEs) on Suicidal Ideation and Suicide Attempts in an Inpatient Adolescent Sample

Background: Suicidal ideation (SI) and suicide attempts (SAs) among adolescents are a significant public health concern worldwide. The current study extends previous research by exploring the association between adverse childhood experiences (ACEs) and SI and SAs in a sample of inpatient adolescents as well as identifying specific predictors for increased risk of SI and SAs. Methods: Associations between ACE scores and self-reported SI and SAs were explored in a sample of 154 inpatient adolescents via clinical interview and by analyzing the association between cumulative ACE scores and scores on the Suicidal Tendency scale of a larger personality measure. We also tested for independent relationships between 19 ACEs and SI and SAs to determine unique predictors for suicidality. Results: One-way ANOVA analyses revealed that those who attempted suicide reported significantly more ACEs compared to those who did not attempt suicide. Witnessing violence in the home, school, or neighborhood and experiences of discrimination increased one’s likelihood to attempt suicide by two to threefold, while sexual abuse, neglect, and physical abuse increased this likelihood by three-to-fourfold. Stepwise linear regression analyses demonstrated that emotional abuse, living with someone who had mental health problems or attempted suicide were most associated with elevated Suicidal Tendency scores on a personality measure. Conclusions: Early identification, education and intervention are imperative to limit or eliminate ACEs from occurring. The impact of cumulative as well as specific ACEs on suicide risk should be closely considered as areas for such intervention. Areas for future research include extending to include more diverse populations such as the LGBTQ community as well as more ethnically and racially diverse populations.

599 Associations between adverse childhood experiences and obstetrical outcomes in an urban underserved population

Adverse childhood experiences (ACEs) such as abuse, neglect, and household dysfunction are strongly associated with poor adult health outcomes in a dose-dependent manner. Less is known about the impact of ACEs on pregnancy, especially in vulnerable populations. The objective of this study was to examine the relationship between ACEs and obstetric outcomes. This is a single-center retrospective cohort study of pregnant women referred to a mental health care coordinator due to elevated psychosocial risks and/or behavioral concerns. Women younger than age 18 and those who did not speak English were excluded. Patients completed validated mental and behavioral health screening tools including the ACE questionnaire. Medical charts were reviewed for obstetric outcomes. The associations between ACE score and adverse obstetric outcomes including preterm birth (<37 weeks), low birth weight (<2500 g), and hypertensive disorders of pregnancy (gestational hypertension and preeclampsia), were analyzed using bivariate analysis and multivariate logistic regression, adjusting for confounding factors (significant at p< 0.1 in bivariate analysis). Our cohort included 92 women of whom 49% had elevated cumulative ACE score ≥ 4 and 26% had a cumulative ACE score ≥ 6. Women with elevated ACE score were significantly more likely to have chronic hypertension; otherwise there were no differences on demographic characteristics or potential obstetric confounds between groups (Table 1). In univariate analysis, ACE score ≥ 4 was not associated with adverse obstetric outcomes, however a score ≥ 6 was associated with an increased risk of preterm birth (OR 3.7, 95% CI 1.2-11.4) and low birth weight (OR 4.9, 95% CI 1.4-17.2). This association did not remain statistically significant after controlling for chronic hypertension. A high level of childhood adversity was associated with chronic hypertension and both prematurity and low birth weight. Future studies should examine whether chronic illnesses help account for poor obstetric outcomes in pregnant women with high childhood adversity.View Large Image Figure ViewerDownload Hi-res image Download (PPT)

The association between adverse childhood experiences and young adult outcomes: A scoping study

Study aimsThis scoping study presents the current status of evidence for young adult outcomes associated with adverse childhood experiences (ACEs) and identifies knowledge gaps in the literature. MethodsArticles were eligible for review if they were published in peer-reviewed journals between 2010 and 2020, were written in English, and reported original empirical research on the impact of ACEs on young adults ages 18–25. Forty-two articles were selected for full review. ResultsMost ACEs instruments included categories of child abuse and family dysfunction; events that occurred in the child’s social environment were less likely to be considered. Prevalence of ACEs varied widely across studies. Prominent young adult outcomes associated with ACEs were mental health problems and substance use. Approximately one third of the reviewed studies examined either mediators or moderators in the relationship between ACEs and young adult outcomes. ConclusionIt is important to obtain clear consensus on the conceptual meaning and components of ACEs. Future studies employing various research methods, such as a longitudinal design, mixed methods, or complex path models, may enhance understanding of how ACEs impact young adult outcomes and what factors might play a role in these relationships.