Occurrence Of Adverse Childhood Experiences Research Articles

The relationship between adverse childhood experiences and depressive symptoms in rural left-behind adolescents: A cross-sectional survey

ObjectiveWe assessed the current status of depressive symptoms and the associated factors in rural left-behind adolescents. Moreover, we investigated the relationship between adverse childhood experiences and depressive symptoms. MethodsStudents from two rural junior high schools in Huaihua City were enrolled from July to September 2022. Before distributing the questionnaires, guardians of the students were contacted, and consent was obtained from the students themselves. The questionnaires were filled out anonymously and collected on-site. ResultsThe prevalence of depressive symptoms among the 325 left-behind teenagers was 23.40%; the rate of emotional abuse in adverse childhood experiences was 17.50%, physical abuse was 15.70%, sexual abuse was 9.50%, emotional neglect was 24.60%, while physical neglect was 27.70%. The five dimensions of adverse childhood experiences were associated with depressive symptoms (r = 0.597, 0.395, 0.410, 0.498, 0.741, p < 0.01). ConclusionsDepressive symptoms were common among rural left-behind adolescents. Adverse childhood experiences were associated with depressive symptoms in rural left-behind adolescents. Occurrence of adverse childhood experiences should be reduced to improve on depressive symptoms.

Are adverse childhood experiences associated with trajectories of healthy aging? Evidence from China

Adverse childhood experiences (ACEs) have life-course impact and may be associated with healthy aging. This study aimed to explore the association between ACEs and healthy aging trajectories among middle- and older-aged adults in China. The data were obtained from the China Health and Retirement Longitudinal Study from 2011 to 2018. A total of 8906 respondents were enrolled in the analysis. Through latent growth mixture model, five categories of healthy aging trajectories which defined as ‘stable type with high starting point’, ‘stable type at the middle level’, ‘stable type with low starting point’, ‘rapid descending type with high starting point’, and ‘stable descending type with medium starting point’ were identified. Based on multinomial logistic regression, ACEs were significantly associated with healthy aging trajectories (stable type at the middle level/stable type with high starting point: relative risk reduction [RRR] = 1.19; P < 0.01; 95% CI = 1.16–1.23; stable type with low starting point/stable type with high starting point: RRR = 1.35; P < 0.01; 95%CI = 1.21–1.51; rapid descending type with high starting point/stable type with high starting point: RRR = 1.09; P < 0.1; 95% CI = 0.99–1.19; and stable descending type with medium starting point/stable type with high starting point: RRR = 1.30; P < 0.01; 95% CI = 1.23–1.38). When treating ACEs as a categorical variable, the healthy aging trajectory of the rapid descending type with a high starting point was not affected by any ACE groups. Further analysis of the relationship between each ACE and the trajectories of healthy aging reveals that parental disability, household mental illness, domestic violence, physical abuse, unsafe neighbourhood and bullying had significant impacts on almost every developmental trajectory of unhealthy aging. The government should promote the realisation of healthy aging from the perspective of the entire population and life cycle, intervene early in life, avoid the occurrence of ACEs as much as possible, and minimize the harm done by ACEs as much as possible.

Association of age of adverse childhood experiences with thalamic volumes and post-traumatic stress disorder in adulthood.

Adverse childhood experiences (ACEs) have been linked to brain development and mental disorders, however, the impact of the age of occurrence of ACEs on thalamic volume and post-traumatic stress disorder (PTSD) after adult trauma remains unclear. This study assessed associations between ACEs at different ages to thalamic volumes and PTSD development following acute adult trauma. Seventy-nine adult trauma survivors were recruited immediately after trauma. Within 2 weeks of the traumatic event, participants completed the PTSD Checklist (PCL) to assess PTSD symptoms, the Childhood Trauma Questionnaire (CTQ) and Childhood Age Range Stress Scale (CARSS) to evaluate ACEs and perceived stress level at preschool (<6 years old) and school (6-13 years old) ages, and structural magnetic resonance imaging (sMRI) to measure thalamic volumes. Participants were divided into three groups: those who experienced no childhood trauma or stress (non-ACEs), those who experienced childhood trauma and stress onset at preschool ages (Presch-ACEs), and those who experienced childhood trauma and stress onset at school ages (Sch-ACEs). At 3 months, participants underwent PTSD symptom evaluation using the Clinician Administered PTSD Scale (CAPS). Adult trauma survivors in the Presch-ACEs group had higher CTQ and CAPS scores. In addition, survivors in the Presch-ACEs group had smaller thalamic volume compared to survivors in the non-ACEs and Sch-ACEs groups. Furthermore, smaller thalamic volume moderated a positive association between post-trauma 2-week PCL and subsequent 3-month CAPS scores. Earlier occurrence of ACEs was associated with smaller thalamic volume, which appears to moderate a positive association between early posttraumatic stress symptom severity and PTSD development after adult trauma. This raises the possibility that early occurrence of ACEs may impact thalamic structure, specifically a reduction in thalamic volume, and that smaller thalamic volume may contribute to susceptibility to PTSD development after adult trauma.

Mediating role of personality traits in the association between multi-dimensional adverse childhood experiences and depressive symptoms among older adults: A 9-year prospective cohort study

BackgroundTo explore the mediating role of personality traits in the correlation between multi-dimensional adverse childhood experiences (ACEs) and depressive symptoms in older adults. MethodsThis cohort study used data from the English Longitudinal Study of Ageing, and included 4050 older adults without depressive symptoms in 2010–2011. Multi-dimensional ACEs were evaluated in 2006–2007. Personality traits were assessed using the Midlife Development Inventory in 2010–2011. Depressive symptoms were measured using the 8-item version of the Center for Epidemiologic Studies Depression Scale during 2012–2019. Cox proportional hazard model was used to explore the associations between ACEs and depressive symptoms. The package named “mediation” in R was used to test mediating role of personality traits. ResultsACEs in each dimension significantly increased the risk of depressive symptoms (all P-values < 0.05). The association of maltreatment (18.18 %) and household dysfunction (19.69 %) with depressive symptoms was significantly mediated by neuroticism. The correlation between poor parent-child bonding and depressive symptoms was significantly mediated by neuroticism (19.43 %), conscientiousness (4.84 %), and extroversion (8.02 %). LimitationsACEs were retrospectively assessed based on participants' memories, which may induce recall bias. ConclusionsMaltreatment and household dysfunction may induce depressive symptoms by increasing neuroticism. Poor parent-child bonding may induce depressive symptoms by increasing neuroticism and reducing conscientiousness and extraversion. In addition to reducing the occurrence of ACEs, reducing neuroticism of individuals with maltreatment and household dysfunction in childhood, and reducing neuroticism, and increasing conscientiousness and extraversion of individuals with poor parent-child bonding in childhood might help to decrease their risk of depressive symptoms.

Prevalence and associated factors of adverse childhood experiences (ACE) in a sample of Brazilian university students

BackgroundAdverse childhood experiences (ACEs) have long been associated with health risk behaviors, but they are poorly studied in Brazilian university students. ObjectiveTo estimate the prevalence of ACEs and investigate their association with sociodemographic data, health risk factors and self-related health in a sample of university students. Participants and settingA cross-sectional study conducted with 546 students from a Brazilian public university. MethodThe self-reported 10-ACE Study questionnaire (ACE-Q) and sociodemographic information (age, sex, family income), health risk factors (body mass index, physical exercise, alcohol and tobacco use) and self-related health were assessed. Chi-square Test and multivariate logistic regression were used to evaluate the association between the cumulative occurrence of ACE (ACE ≥4) and the studied factors. ResultsOf the 546 participants, 464 responded to all ACE-Q questions; 74.4% reported at least one ACE, and 13.1 % reported four or more. Lower family income (OR = 2.02; 95%CI = 1.13–3.61; p = 0.01) and self-related poor health (OR = 2.29; 95%CI = 1.28–4.08; p = 0.00) were associated with the occurrence of ACE ≥4. ConclusionMost students reported at least one ACE, while a minority reported ≥4 ACEs associated with lower family income and poor self-health. The data suggest that preventive actions should be considered to mitigate the problem, with lower-income students being treated as a priority.

Building Infrastructure for Surveillance of Adverse and Positive Childhood Experiences: Integrated, Multimethod Approaches to Generate Data for Prevention Action

Adverse and positive childhood experiences have a profound impact on lifespan health and wellbeing. However, their incorporation into ongoing population-based surveillance systems has been limited. This paper outlines critical steps in building a comprehensive approach to adverse and positive childhood experiences surveillance, provides examples from the Preventing Adverse Childhood Experiences: Data to Action cooperative agreement, and describes improvements needed to optimize surveillance data for action. Components of a comprehensive approach to adverse and positive childhood experiences surveillance include revisiting definitions and measurement, including generating and using uniform definitions for adverse and positive childhood experiences across data collection efforts; conducting youth-based surveillance of adverse and positive childhood experiences; using innovative methods to gather and analyze near real-time data; leveraging available data, including from administrative sources; and integrating data on community- and societal-level risk and protective factors for adverse childhood experiences, including social and health inequities such as racism and poverty, as well as policies and conditions that create healthy environments for children and families. Comprehensive surveillance data on adverse and positive childhood experiences can inform data-driven prevention and intervention efforts, including focusing prevention programming and services to populations in greatest need. Data can be used to evaluate progress in reducing the occurrence of adverse childhood experiences and bolstering the occurrence of positive childhood experiences. Through expansion and improvement in adverse and positive childhood experiences surveillance—including at federal, state, territorial, tribal, and local levels—data-driven action can reduce children’s exposure to violence and other adversities and improve lifelong health and well-being.

Food insecurity and adverse childhood experiences: a systematic review.

Food insecurity (FI) and adverse childhood experiences (ACEs) disproportionally affect vulnerable populations and are key social determinants of health that predict nutrition-related outcomes. It is critical to understand how FI and ACEs are interrelated so prevention studies can be designed to better promote health equity. A systematic literature review was conducted using the Preferred Reporting Items for Systematic Reviews and Meta-Analyses to determine the association between FI and ACEs. Google Scholar, PubMed, and Scopus databases were used to find articles relevant to the study. Inclusion criteria included quantitative, qualitative, or mixed-methods studies of humans, using an experimental or observational research design to examine the relationship between FI and ACEs using the validated ACEs measure in its entirety. Studies were assessed for study design, data set, population descriptions, and results of the association between FI and ACEs. Additionally, all included studies were assessed for bias and validity. A total of 10 articles were included in the systematic review. Of those articles, 9 were reports on cross-sectional studies, and 1 reported on a longitudinal study; however, all 10 studies used a retrospective approach. Six studies were conducted using secondary data. Results reported in all 10 articles indicated a significant positive association between FI and ACEs. Evidence indicated greater odds of FI among individuals with high ACE scores, with most studies indicating a dose-response or a threshold effect of higher ACEs being associated with more severe FI. FI and ACEs are consistently related. Prevention study interventions should be designed to address FI and problems stemming from ACEs. Filling knowledge gaps regarding the relationship between ACEs and FI is critical for designing nutrition interventions that promote food security, prevent the occurrence of ACEs, and improve health outcomes among vulnerable populations with high ACEs. PROSPERO registration no.: CRD42020210106.

1177Lest we lose focus: ongoing analyses of adverse childhood experiences in COVID-19 era

BackgroundToxic stress caused by adverse childhood experiences (ACEs) has been definitively linked to adverse health outcomes across lifespan. Prolonged COVID-19 pandemic stress affecting mental and physical health across the nation, has been postulated to amplify occurrence of ACEs and exacerbate negative health outcomes in this vulnerable population. This study provides a comparison of pre COVID (year 2019) and COVID (year 2020) data on ACE’s and health outcomes.Methods2019 and 2020 Behavioral Risk Factor Surveillance System data were analyzed to estimate the prevalence of childhood adversity and association with health behaviors and outcomes. Logistic regression was performed using SAS complex survey procedures.ResultsIn 2019,nearly one in four adults reported high ACE scores (≥3). High ACE scores were more prevalent among women, multiracial/minority race groups, bisexual, lesbian/gay sexually oriented, younger age group, adults, less educated, and with lower income. Comparison analyses with 2020 data has begun and is expected to be completed in time for conference presentation.ConclusionsOngoing focus on ACEs mitigation and/or prevention efforts is critical to better health and higher socioeconomic attainment across lifespan. COVID-19 pandemic has escalated and put a spotlight on this call . Adults with preexisting ACEs are especially vulnerable. Compounded toxic stress with limited access to health care can expedite development or worsening of chronic conditions in these susceptible groups.Key messagesTargeted efforts to identify and protect at-risk ACEs populations from the negative impact of COVID 19 pandemic are essential.

Families in the COVID-19 pandemic: parental stress, parent mental health and the occurrence of adverse childhood experiences—results of a representative survey in Germany

Parenting during the COVID-19 pandemic is highly challenging, with parents having to meet various demands simultaneously. An increase in adverse childhood experiences (ACEs) has been widely predicted, but empirical evidence is still scarce. This study aimed to (1) generate representative data on pandemic-related stress, parental stress, general stress, parental subjective and mental health, and the occurrence of ACEs; (2) identify risk factors for an increase in ACEs, and (3) provide qualitative data on parents’ experiences. A representative survey was conducted in Germany in August 2020 with 1024 parents of underage children (Mage = 41.70, 50.9% female). More than 50% of parents reported being stressed by social distancing and the closure of schools and childcare facilities. Parental stress increased significantly during the pandemic (d = 0.21). Subgroups of parents also reported very high levels of depressive symptoms (12.3%) and anxiety (9.7%). Up to one-third of the sample reported ACEs in the child’s lifetime. In this group, 29.1% reported an increase in children witnessing domestic violence during the pandemic, and 42.2% an increase verbal emotional abuse. These families were characterized by higher parental stress, job losses, and younger parent and child age. Positive aspects of the pandemic related primarily to personal or family life (e.g. slower pace of life, increase in family time). While some parents coped well, a particularly negative pattern was observed in a subgroup of families that experienced an increase in ACEs. Parental stress emerged as important target point for interventions addressing the negative sequelae of the pandemic.

Multiple adverse childhood experiences and asthma onset in adulthood: Role of adulthood risk factors as mediators

ObjectiveThis population-based study of 21,902 Finnish adults examined whether adulthood risk factors for asthma mediate the association between the exposure to multiple adverse childhood experiences (ACEs) assessed retrospectively and the risk of new-onset asthma in adulthood. MethodsBaseline characteristics, occurrence of ACEs, and risk factors of asthma in adulthood were collected with a postal survey at baseline in 1998. The participants were linked to records on incident asthma from national health registers from 1999 to 2012. Counterfactual mediation analysis was used to examine the effects of multiple ACEs (≥2) on asthma through adulthood risk factors of asthma (mediators). ResultsOf the 21,902 participants without asthma at baseline, 7552 (34%) were exposed to multiple ACEs during childhood. During the follow-up period, 2046 participants were diagnosed with incident asthma. Exposure to multiple ACEs increased the risk of asthma onset by 31% compared with ≤1 ACE. The association between ACEs and asthma onset was partly mediated by the following adulthood risk factors: severe life events (29%), smoking (15%), allergic rhinitis (8%), low education level (6%), and obesity (3%). Specific stressful life events mediating the ACE–asthma association were ‘severe financial difficulties’ (24%), ‘emotional, physical or sexual violence’ (15%), ‘major increase in marital problems’ (8%), ‘severe conflicts with supervisor’ (7%), and ‘divorce or separation’ (5%). ConclusionsExposure to multiple ACEs increased the risk of asthma in adulthood. Adulthood risk factors of asthma mediated a significant proportion of the effect of ACEs on the risk of asthma onset.

Childhood adversity in patients suffering from depression with a focus on differences across gender

Context: Childhood adversity is highly prevalent and is associated with depression. Aims: The aim of the study is to assess the occurrence of adverse childhood experiences (ACEs) in male and female patients suffering from depression, measure its relationship with the severity of depression, and evaluate the association of factors across gender. Settings and Design: A cross-sectional study was conducted. Subjects and Methods: A total of 100 adult depressed patients were evaluated to calculate the severity of depression and the ACE score. Statistical Analysis Used: Statistical analysis was performed using Chi-square test and binary logistic regression. Results: One or more categories of ACEs were reported in 70% of male and 68% of female patients. The most common was violence between adults in the household and physical abuse. In male patients, there was a significant association between severity of depression and experiencing three or more categories of childhood adversity (P = 0.01). Conclusions: Childhood adversity occurs frequently and is associated with severity of depression in the male cohort.

Progress in research of association of adverse childhood experiences with prevalence of common chronic diseases in adulthood

The effects of adverse childhood experiences on adult health has aroused increasing concern in the world in recent years, but limited studies have been conducted in China. This study synthesized the measurement of adverse childhood experiences, the association between adverse childhood experiences and the prevalence common chronic diseases in adulthood and possible mechanisms. It was found that though measurement range of adverse childhood experiences might be different among studies, current used measurement scales basically met the requirement of disease prevention. Most categories of adverse childhood experiences were positively related to risk of common chronic diseases, and the relationship was influenced by social economic status, sex and age. However, people with exposure to famine in childhood had lower prevalence of hypertension compared with those without the exposure. The possible mechanisms might be that the occurrence of adverse childhood experiences might damage physiological functions or increase the adoption of poor healthy behaviors and lifestyles, and finally increased the risk of chronic diseases directly or indirectly. While premature death due to adverse childhood experiences might reverse the association because of nonrandom selection. It is necessary for us to select appropriate indexes of adverse childhood experiences and conduct more studies to prove the association between adverse childhood experiences and prevalence of common chronic diseases in adulthood and explore the related mechanism for the better prevention of chronic diseases in China.

Prevalence and Predictors of Adverse Childhood Experiences among Youths in Rural communities of Oyo State, South-west, Nigeria

Background: Adverse Childhood Experiences (ACEs) are traumatic events a child is exposed to early in life. It is a global problem that constitutes a public health concern. However, few studies have been conducted on ACEs in low- and middle-income countries (LMICs) like Nigeria. This study assessed the prevalence and predictors of ACEs among youths in rural communities in Oyo State, South-west, Nigeria.Methods: A cross-sectional survey was conducted among 575 youths selected by multistage sampling technique. A structured interviewer-administered questionnaire was used to obtain information on exposure to ACEs; abuse, neglect and household dysfunctions among respondents. Data were analyzed with SPSS version 21.0. Associations were explored with chi-square test and logistics regression analysis. Level of significance was set at 5%.Results: The mean age (SD) of respondents was 26.3 (4.9) years. Three hundred and forty-two (59.5%) respondents were males, 252 (43.8%) had secondary education and 276 (24.5%) were classified into the lowest wealth quintiles. Most respondents 529 (92%) reported they had experienced ACEs. Most prevalent ACEs were psychological neglect 247 (42.9%), physical neglect 236 (41.0%), psychological abuse 231 (40.2%) and household substance abuse 223 (38.8%). The predictors of experiencing ACEs were having a mother with primary education and below (AOR=2.61; CI=1.383.51) and being in the lowest wealth quintile (AOR=1.53 CI=1.24-2.87).Conclusion: Poor education and poverty contributed to the high occurrence of ACEs among youths in rural south-west. Strategic interventions by government/organizations to improve parental education and ameliorate poverty may be beneficial in reducing ACEs and ensure optimal child development.&#x0D; Keywords: Adverse childhood experiences; Predictors; Youths; Rural; Nigeria

"I Don’t Even Deserve a Chance": An Ethnographic Study of Adverse Childhood Experiences Among Male Perpetrators of Intimate Partner Violence

Perpetrators of intimate partner violence (IPV) are more likely to have been exposed to adverse childhood experiences (ACES) than the general population (e.g., Whitfield, Anda, Dube, &amp; Felitti, 2003). Despite this association, occurrence of ACES does not necessarily lead to the development of patterned abusive behavior (Godbout et al., 2017). To understand the link between ACES and IPV perpetration, Godbout et al. (2017) suggest that research must consider a complex array of intra- and interpersonal experiences. For this project, we used ethnographic methods, including participant observation at a local batterer intervention program (BIP) and semi-structured interviews with 15 male IPV perpetrators to explore the individual experiences in greater detail. The data were analyzed using a combination of concept-driven, open, and axial coding, creating an inductive and iterative process for interpretation (e.g., Manning &amp; Kunkel, 2014). Participants’ reports revealed high frequency of often co-occurring ACES, with patterns of negative messages about self-worth, beliefs about personal responsibility for experiences of abuse, and both feelings of powerlessness in the face of abusers and the need to feel powerful. Results are discussed regarding the theoretical understanding of individual differences among IPV perpetrators. Specifically, we address the practical need to expand our investigation of ACES, as experienced by IPV perpetrators, to include more varied types of abuse and household dysfunction.

Adverse childhood experiences among foster parents: Prevalence and association with resilience, coping, satisfaction as a foster parent, and intent to continue fostering

Foster parents provide substitute, primary care for children who have been removed from their primary caregivers due to abuse and neglect. Little is known about the experiences of foster parents prior to fostering, particularly whether they have experienced adversity themselves, such as adverse childhood experiences (ACEs). The purpose of this study was to examine the occurrence of ACEs among a convenience sample of foster parents and explore multiple relationships between foster parent-reported ACEs, resilience, and other indicators of foster parent function and well-being (parental stress, satisfaction as a foster parent, perceived challenges with fostering, intent to continue fostering). This study included a convenience sample of 150 non-relative foster parents from across the United States who were currently fostering. Authors utilized descriptive statistics to describe occurrence of ACEs, regression analyses to examine associations between study variables, and t tests to address differences in resilience and fostering outcomes based on experience of ACEs. Sixty-eight percent (68%) of foster parents in this sample experienced one ACE or more. Results indicated that there were no relationships between ACEs and foster parent outcomes, except that foster parents with at least one ACE reported more challenges with the foster care system. Parental resilience was associated with parental stress, satisfaction, and intent to continue fostering. The results of this study indicate that early adversity may be less important than foster parent resilience, particularly considering that resilience is both genetic and something that can be taught. Thus, researchers and child welfare practitioners or administrators should understand and integrate foster parent training and supports that can build foster parent resilience.

Adverse childhood experience and rheumatic diseases.

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

Adverse childhood experiences and consumption of alcohol, tobacco and illicit drugs among adolescents of a Brazilian birth cohort.

The objective of this study was to investigate the association between adverse childhood experiences (ACEs) and the use of alcohol, tobacco and illicit drugs among adolescents from a Brazilian cohort. The occurrence of five ACEs, the use of alcohol and tobacco and trying illicit drugs were investigated in the 1993 Pelotas birth cohort at the age of 15 (n = 4,230). A score was created for the ACEs and their association with the use of substances was evaluated. Around 25% of adolescents consumed alcohol, 6% smoked and 2.1% reported having used drugs at least once in their lives. The ACEs were associated with the use of alcohol, tobacco and illicit drugs. A dose-response relation between the number of ACEs and the substance use was found, particularly with regard to illicit drugs. The occurrence of ACEs was positively associated with the use of alcohol, tobacco and illicit drugs among adolescents and the risk may be different for men and women. These results point to the fact that strategies for preventing the use of substances should include interventions both among adolescents and within the family environment.

Adverse childhood experiences: Prevalence and related factors in adolescents of a Brazilian birth cohort

Adverse childhood experiences (ACEs) can affect people's health and wellbeing not only at the time the ACE is experienced, but also later in life. The majority of studies on ACEs are carried out in high-income countries and little is known about its prevalence in low and middle-income countries. Thus, the aim of this study was to assess the prevalence of ACEs, associations between ACEs and sociodemographic factors, and the interrelationship between types of ACEs in adolescents of a Brazilian birth cohort. Data from 3,951 adolescents (78.4% of the original cohort) from the 1993 Pelotas Cohort were analyzed. Seven types of ACEs were assessed in those up to 18 years old: physical abuse, sexual abuse, physical neglect, emotional neglect, domestic violence, parental separation and parental death. The most common ACE was parental separation (42%), followed by emotional neglect (19.7%) and domestic violence (10.3%). Approximately 85% of the adolescents experienced at least one ACE, and females reported a higher number of adversities. Several socioeconomic, demographic and family-related characteristics were associated with the occurrence of ACEs, e.g. non-white skin color, low family income, low maternal schooling, absence of mother's partner, maternal smoking, and poor maternal mental health. A strong interrelationship was observed among the ACEs, indicating clustering of risk. These aspects should be considered by health and social care professionals in the prevention and identification of childhood adversities.

Adverse childhood experiences of persons at risk for Huntington's disease or BRCA1/2 hereditary breast/ovarian cancer

Huntington's disease (HD) is known to have a negative impact on family life. Offspring of HD patients may be exposed to adversity in childhood because of the parent's disease and its psychological consequences. BRCA1/2 hereditary breast and ovarian cancer (BRCA1/2) increases the risk for offspring of being exposed to parental disease or loss. Childhood adversity is associated with psychopathology and various other problems in later life. Adverse childhood experiences (ACEs) before age 16 were assessed in adults at 50% risk for HD (n = 74) or BRCA1/2 (n = 82) and in controls (n = 101), using the Negative Life Events Scale. Mean number and occurrence of ACEs were compared between groups. The odds of having experienced adversity in childhood were higher in HD offspring and BRCA1/2 offspring than in controls. HD offspring reported a higher mean number of ACEs than controls or BRCA1/2 offspring. In HD offspring, the prevalence of parental disease and parental dysfunction experienced before age 16 was higher than in controls. In BRCA1/2 offspring, the prevalence of parental loss before age 16 was higher than in controls. This study indicates that 53% of HD offspring and 45% of BRCA1/2 offspring are exposed to adversity in childhood or adolescence. The relevance of these findings for counseling in predictive testing programs, reproductive decision-making, and child rearing matters is discussed.