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Background: Adverse childhood experiences (ACEs) are associated with mental health problems, but many children who experience ACEs do not develop such difficulties. A warm and supportive adult presence in childhood is associated with a lower likelihood of developing mental health problems after exposure to ACEs. However, it is unclear whether this association is causal, as previous research has not accounted for genetic and environmental confounding., Methods: We used the twin-difference design to strengthen causal inference about whether a warm and supportive adult presence protects children exposed to ACEs from mental health problems. Participants were from the Environmental Risk (E-Risk) Longitudinal Twin Study, a UK population-representative birth cohort of 2,232 same-sex twins. ACEs were measured prospectively from ages 5 to 12. Maternal warmth was assessed at ages 5 and 10 through maternal speech samples. Adult support was assessed through child reports at age 12. Mental health problems were assessed through interviews at age 12 with parents and teachers and participants at age 18., Results: Among children exposed to ACEs, those who experienced greater maternal warmth and adult support had lower levels of mental health problems at ages 12 and 18. In monozygotic twin-difference analyses, the protective effects of maternal warmth and adult support on mental health were attenuated by 70% for maternal warmth and 81% for adult support, compared to phenotypic analyses. Twins who experienced greater maternal warmth and adult support had minimal or no difference in mental health compared to their co-twins, concordant for ACE exposure., Conclusions: The apparent protective effect of a warm, supportive adult against mental health problems following ACEs is largely explained by genetic and environmental confounding. This suggests that interventions which boost maternal warmth and adult support should be supplemented by components addressing wider family environments and heritable vulnerabilities in children exposed to adversity, to improve mental health., (© 2024 The Author(s). Journal of Child Psychology and Psychiatry published by John Wiley & Sons Ltd on behalf of Association for Child and Adolescent Mental Health.)

Background: Adverse childhood experiences (ACEs) are strong, preventable risk factors for emotion dysregulation in adolescence, but whether ACEs-emotion dysregulation associations differ by race/ethnicity or gender remains unclear., Objective: We examined (a) how race/ethnicity and gender jointly impact latent ACEs classes and emotion dysregulation phenotypes, and (b) how these ACEs classes in childhood (by age 9) transition to latent emotion dysregulation phenotypes in adolescence (at age 15)., Participants and Setting: Participants were 3,273 children from two waves of data from the Future of Families and Child Wellbeing Study, a large, nationally representative cohort. The sample consisted of 26.6% non-Hispanic (NH) Black boys, 25.4% NH Black girls, 12.9% Hispanic boys, 12.6% Hispanic girls, 11.8% NH White boys, and 10.7% NH White girls., Method: We estimated latent class models to identify ACEs patterns across ten indicators and dysregulation phenotypes across affective, attentional, and behavioral domains. Latent transition analysis was used to examine how ACEs classes transitioned into dysregulation phenotypes from childhood into adolescence., Results: The findings revealed significant variation in the number and nature of latent classes of both ACEs and emotion dysregulation across the intersection of race/ethnicity and gender. NH Black and Hispanic children were more likely to be in the Poverty and Parental Separation class than NH White children. Hispanic boys had the highest prevalence of Severe Dysregulation (16%), whereas NH White boys had the highest prevalence of Low Symptoms (52%). Individuals in the Poverty and Parental Separation class had a higher probability of transitioning to the Low Symptoms class. In contrast, those in the Abuse and Family Dysfunction class were more likely to transition to the Severe Dysregulation class, with NH White girls showing the highest probability (.34), nearly twice that of NH Black girls (.19). These gender differences in these transition probabilities were observed for Whites but not Blacks., Conclusions: These findings thus highlight the need for adopting an intersectional, person-centered approach when studying the effects of ACEs on adolescent development., Competing Interests: Declaration of competing interest The authors have no conflicts of interest to report., (Copyright © 2024 Elsevier Ltd. All rights reserved.)

Establishing and maintaining social relationships is a critical developmental milestone for adolescents and young adults and can be disrupted by childhood adversities. Adverse and positive childhood experiences (ACEs and PCEs, respectively) represent independent, yet critical, domains that support the exploration of positive and adverse childhood experiences (PACEs) as pathways to social connection. Recent research has examined the impact of COVID-19 on child development. The current study expands on existing research by examining the effects that PACEs clusters and high school enrollment during COVID-19 had on social connectedness. Young adults (N = 211; M age  = 20.97 years, SD = 2.14) completed an online survey examining social functioning and childhood experiences. Two measures comprised PACEs: Benevolent Childhood Experiences (BCEs) scale and Adverse Childhood Experiences questionnaire. An adapted Berkman-Syme Social Network Index measured social connection. High school enrollment during COVID-19 was determined by graduation year. Cluster analyses identified three PACEs profiles: (1) high BCEs/low ACEs (74.9%), (2) moderate BCEs/high ACEs (14.7%), and (3) low BCEs/moderate ACEs (10.4%). Regression analyses showed that High Risk/High Protection (β = -3.326, p = .001) and Moderate Risk/Moderate Protection (β = -4.845, p < .001) profiles had significantly fewer social connections than the Low Risk/High Protection profile. High school enrollment at the COVID-19 onset did not predict social connection (β = 0.067, p = .305). Implications include clinicians considering PACEs when forming a holistic view of clients and integrating positive contexts into adversity research., (Copyright © 2024 Elsevier Inc. All rights reserved.)

Female offenders released from prison often face challenges within the community such as lack of employment, inconsistent attendance in substance use treatment, and complying with parole and probation conditions, which typically decreases their self-efficacy and motivation to refrain from reoffending. Despite this, much is still unknown of psychological factors that could impact female offenders' attitudes toward self-efficacy, such as mental illness symptoms, Adverse Childhood Experiences (ACEs), and personality differences. Thus, this cross-sectional study explored whether mental illness symptoms, ACEs, and personality differences were associated with attitudes toward self-efficacy ( N = 398). Results suggest that mental illness symptoms, ACEs, and neuroticism negatively associated with attitudes toward self-efficacy in contrast to extraversion and conscientiousness. Parole/probation reentry and therapeutic implications are discussed., Competing Interests: Declaration of Conflicting InterestsThe author(s) declared no potential conflicts of interest with respect to the research, authorship, and/or publication of this article.

Background: The detrimental effects of childhood neglect on adult health outcomes are well-recognized; however, less is known about factors that may attenuate this relationship., Objective: (1) To examine the associations between childhood neglect and various physical and mental health outcomes in adulthood among those who had not experienced childhood physical or sexual abuse; and (2) To determine whether adjusting for risk and protective factors, including socioeconomic status, health behaviors, and the presence of a trusted adult, attenuates these relationships., Participants and Setting: Data came from the 2021 Behavioral Risk Factor Surveillance System (BRFSS), a representative sample of community-dwelling US adults (n = 41,322)., Methods: The relationships between childhood neglect and health outcomes were investigated using logistic regression analyses. Adjustments were made for demographics, socioeconomic status, health behaviors, and the presence of a protective adult., Results: Childhood neglect was significantly associated with adverse health outcomes, including health behaviors (e.g., smoking, low physical activity), physical health indicators (e.g., self-reported fair/poor health, stroke, asthma, COPD), disabilities (e.g., hearing impairment, vision impairment, cognitive impairment, difficulty walking or climbing stairs, difficulty bathing), and mental health indicators (e.g., poor mental health/past month, depression) after controlling for demographics. All significant associations indicated small or very small effect sizes. Associations were substantially attenuated when controlling for adult socioeconomic status, and further attenuated when controlling for the presence of a protective adult, with several outcomes becoming non-significant., Conclusions: Socioeconomic status and the presence of a protective adult in childhood considerably diminishes the association between childhood neglect and health outcomes in adulthood., (Copyright © 2024 The Authors. Published by Elsevier Ltd.. All rights reserved.)

Objectives: Adverse childhood experiences (ACEs) are associated with frailty, while the association with frailty state transitions and the role of social participation remain unclear. This study aimed to investigate the association between ACEs and frailty state transitions, alongside the moderating effect of social participation METHODS: Data from 9,621 adults aged 45 and older from the China Health and Retirement Longitudinal Study (2011-2020) were analyzed. Frailty was measured with the frailty index, while ACEs and social participation were measured with a validated questionnaire. The association between ACEs and frailty state transitions was estimated using multi-state models. An interaction analysis were used to examine the moderating effects of social participation., Results: Participants with higher ACEs scores (≥4) were associated with an increased probability of forward transition (robust to pre-frail, HR = 1.37, 95%CI: 1.21-1.54; prefrail to frail, HR = 1.39, 95%CI: 1.18-1.63) and decreased probability of backward transition (pre-frail to robust, HR = 0.64, 95%CI: 0.55-0.76). Additionally, participants with moderate and high level social participation were associated with an increased probability of backward transition (pre-frail to robust, HR = 1.11, 95%CI: 1.01-1.23; frail to pre-frail, HR = 1.17, 95%CI: 1.02-1.33, respectively). Social participation moderated the association between ACEs exposure and frailty (P for interaction <0.05), while participants with lower ACEs scores (1 and 2) and high social participation were associated with an increased probability of transition from frail to pre-frail (HR = 1.26, 95%CI: 1.04-1.89 and HR = 1.15, 95%CI: 1.08-1.69)., Conclusions: High ACEs scores were associated with an increased likelihood of adverse frailty development. Older adults with ACEs exposure might benefit from intervention strategies to improve social participation., Competing Interests: Declaration of competing interest None declared., (Copyright © 2024 The Authors. Published by Elsevier Masson SAS.. All rights reserved.)

Adverse childhood experiences (ACEs) have been linked with attachment insecurity and psychopathology. However, some individuals remain securely attached and resilient following ACEs. Researchers have examined polymorphisms in the oxytocin receptor gene (OXTR), particularly rs53576, as a source of resilience, though examination of the biological mechanism by which rs53576 buffers the relation that would otherwise exist between ACEs and attachment insecurity is absent. The aim of the current study was to examine how ACEs interact with individual genetic and immune vulnerability to shape attachment security in older adolescents and young adults (n = 201). Moderated mediational models were tested in which ACEs acted as independent variables, attachment security acted as a dependent variable, inflammation (i.e., IL-6) was tested as a mediator, and rs53576 (i.e., AA, AG, GG genotypes) was tested as a moderator. Results indicated that physical abuse was significantly associated with decreased attachment security, with moderation by rs53576. A significant main effect of rs53576 on IL-6 was also noted. A similar pattern of results was evident across other ACEs and suggests that the effects of ACEs on attachment are buffered by the GG genotype. Association between GG and lower IL-6 suggests inflammation plays some role, though more research is needed., (© 2024. The Author(s), under exclusive licence to Springer Science+Business Media, LLC, part of Springer Nature.)

Adverse childhood experiences (ACEs) are strongly associated with impaired cognitive control, yet research on ACEs' effects across cognitive control domains-working memory, cognitive flexibility, and inhibitory control-remains sparse. This systematic review and meta-analysis evaluated the overall impact of ACEs on each of these cognitive control domains and explored moderating factors such as age, gender, cognitive control paradigms, and ACEs subtypes based on the dimensional model of adversity and psychopathology. A database search was conducted in SCOPUS, MedLine, PsycINFO, and Web of Science. Only prospective studies were included to ensure temporal order inferences, with at least two data collection points, assessing ACEs at baseline (T1) and cognitive control during follow-up (T2). Thirty-two studies ( N  = 26,863) producing 124 effect sizes were analyzed. Three-level meta-analyses revealed small-to-medium negative associations between ACEs and overall cognitive control ( g  = -0.32), and in each domain: working memory ( g  = -0.28), cognitive flexibility ( g  = -0.28), and inhibitory control ( g  = -0.32). The negative associations between ACEs and cognitive control were consistent across age, gender, and cognitive control paradigms. ACEs subtypes moderated the association with cognitive flexibility ( p  = .04) but not working memory or inhibitory control. Specifically, the deprivation subtype exhibited a stronger negative association with cognitive flexibility compared to threat and threat-and-deprivation subtypes. These findings highlight the pervasive negative impact of ACEs on cognitive control across ages and emphasize the need for targeted interventions. Implications, current gaps, limitations in research, and future study recommendations are discussed., Competing Interests: Declaration of Conflicting InterestsThe author(s) declared no potential conflicts of interest with respect to the research, authorship, and/or publication of this article.

Background: Early life socioeconomic disadvantage and adverse experiences may lead to overeating, which is in turn associated with increased body mass index (BMI). However, recent evidence indicated that the association between childhood BMI and overeating might be bidirectional. This bidirectionality prompts the need for further investigation of early life predictors of BMI in childhood., Objectives: To longitudinally assess the directionality of the association between childhood BMI and perceived overeating and to investigate their antecedent early life predictors., Methods: The sample included data from 5151 children from the ELSPAC study, collected between 18 months and 11 years of child age. The outcomes were child BMI and mother-reported overeating, assessed at the age of 3, 5, 7 and 11 years. Predictors included maternal BMI, maternal education, single parenthood, financial difficulties and adverse childhood experiences (ACEs) reported by parents and paediatricians. The random intercept cross-lagged panel model was applied., Results: The mean child's BMI at age 3 was 15.59 kg/m 2 and increased to 17.86 kg/m 2 at age 11. The percentage of parent-reported overeating increased in the following period, from about 12% at age 3 to 17% at age 11. The results showed temporal stability in perceived overeating and BMI, with a bidirectional relationship strengthening over time. The child's BMI was associated with maternal BMI. Maternal BMI was positively associated with child-perceived overeating, but a stronger effect was found for ACEs. ACEs mediated the impact of maternal education, financial difficulties and single parenthood on overeating., Conclusions: We observed stable bidirectional associations between BMI and perceived overeating. The results indicated two main pathways: one linked to maternal BMI and early childhood BMI increase followed by perceived overeating and the second associated with ACEs mediating the effect of early childhood social factors on perceived overeating, leading to gradual BMI gain., (© 2024 The Author(s). Pediatric Obesity published by John Wiley & Sons Ltd on behalf of World Obesity Federation.)

Background: Immigrants, asylum seekers, and refugees live with extreme stress, consistent vulnerability, and life-long health consequences. Children in these populations face an increased risk of poor mental health because of adverse childhood experiences (ACEs)., Aim: To implement an ACE screening questionnaire for all migrant children aged < 19 years in a community shelter., Method: The Model for Improvement., Intervention: The Pediatric ACEs and Related Life Events Screener was implemented over 10 weeks in a community shelter., Results: All children screened had at least 1 ACE. Initiation of screening led to the recognition of adverse experiences, thus allowing for mental health support and referrals to mental health specialists., Conclusions: This quality improvement project supports screening for ACEs in migrant children to uncover potential mental health concerns and provide targeted support, recognizing the long-term effects of trauma on their well-being., Competing Interests: CONFLICTS OF INTEREST None to report., (Copyright © 2024 National Association of Pediatric Nurse Practitioners. Published by Elsevier Inc. All rights reserved.)

Background: Addressing the long-term physical and mental health impacts of adverse childhood experiences (ACEs) remains a significant public health challenge. Additionally, ACEs can contribute to intergenerational transmission, affecting future generations. While previous studies have primarily focused on children and adolescents, there is limited data on ACE subtypes and influencing factors among the general adult population, particularly in China. This study aims to explore the prevalence, subtypes, and factors influencing ACEs among Chinese adults., Method: A total of 1,932 Chinese residents from southwest China (Sichuan, Yunnan, Guizhou provinces, and Chongqing Municipality) participated in the study, consisting of 867 men (44.9%) and 1,065 women (55.1%). Latent class analysis (LCA) was used to identify ACE clusters, and regression analysis examined associations between ACE clusters and demographic factors, physical illness, and mental health outcomes., Results: The findings revealed that 28.7% of participants had experienced at least one ACE, while 13.2% had experienced three or more ACEs. Three distinct ACE clusters were identified: a low ACE group, a high emotional and physical abuse/family dysfunction group, and a high ACE/sexual abuse group. Regression analysis showed significant associations between childhood adversity and demographic factors (age, education, birthplace), as well as physical and mental health outcomes (anxiety, depression). ANOVA further confirmed significant differences in depression and anxiety scores across the clusters., Conclusion: These findings offer critical insights for developing targeted public health interventions. Policymakers should consider strategies to reduce childhood ACEs and mitigate their long-term consequences, with particular attention to high-risk groups., Competing Interests: The authors declare that the research was conducted in the absence of any commercial or financial relationships that could be construed as a potential conflict of interest., (Copyright © 2024 Chen, Lu, Wen, Zhou and Ke.)

The objective of this constructivist grounded theory study was to understand the experiences of students who have been disciplinarily excluded from school. Fifteen students (male, n  = 11; Black, n  = 10; having special education needs, n  = 9) and 16 multidisciplinary staff in Ontario participated. Students experienced high rates of expanded adversities, including school and community violence, systemic racism and inequity. The importance of connection wove throughout the data; however, three themes were found to block connection: unacknowledged impact of adversity, a climate of fear, and the disproportionate impact of limited resources. Trauma-informed culturally attuned approaches that focus on the disproportionate impact of adversity and school discipline at the point of a disciplinary response, and throughout a student's educational experience, are essential., Competing Interests: The author(s) declared no potential conflicts of interest with respect to the research, authorship, and/or publication of this article., (© The Author(s) 2024.)

This study examines whether adverse childhood experiences (ACEs) predict long-term health issues and how ACEs, alongside stress, impact well-being and cognitive abilities in older adults. 279 adults were categorized into three age groups (30-46, 47-60, and 61-80). Participants completed an online survey assessing health problems, stress, resilience, and ACEs. Additionally, 32 older adults underwent cognitive tests. ACE scores predicted physical and psychological diseases in adults but not in older adults. However, a significant correlation between ACEs and cognitive abilities was evident in older participants. ACEs are significant indicators of long-term health issues and stress in adults but may not predict these factors in older individuals. Understanding ACEs' impact on cognitive abilities in older adults is crucial for tailored interventions and support., Competing Interests: Declaration of conflicting interestsThe authors declared no potential conflicts of interest with respect to the research, authorship, and/or publication of this article.

Introduction: Adverse childhood experiences (ACEs) and social determinants of health (SDoH) are associated with increased incidence of pediatric obesity. Recent literature highlights an imperative need to assess ACEs and SDoH among youth and families with obesity to identify those individuals requiring targeted interventions. The primary objective of the present study was to examine the frequency, methodology, and barriers in evaluation of ACEs and SDoH within pediatric weight management programs (PWMPs). Methods: Invitations were e-mailed to a comprehensive directory of 92 PWMPs in the United States with a link to complete an electronic survey. Results: Forty-one PWMPs from 26 states completed the survey. Assessment of one or more ACEs and SDoH was common and typically took place during the initial patient visit by the psychologist or medical practitioner through unstructured conversations. Reported barriers to assessment included lack of time to assess and to follow-up, lack of clinic protocols, and inadequate referral resources. Programs offering bariatric surgery and those with embedded mental health clinicians reported fewer barriers to ACEs/SDoH referral resources, while family-based and healthy lifestyle-focused programs perceived more barriers related to insufficient support staff and time to follow-up with families. Conclusions: Most PWMPs assess a subset of ACEs and SDoH; however, approaches to assessment vary, are often unstructured, and several barriers remain to optimizing assessment and follow-up. Future research should evaluate standardized ACEs/SDoH assessment protocols, ideal workflow, and their impact on obesity treatment and related health outcomes.

Purpose of Review: Obesity is an overwhelmingly common medical entity seen in the adult population. A growing body of research demonstrates that there is a significant relationship between child maltreatment and adult obesity., Recent Findings: Emerging research demonstrates a potential dose-response relationship between various types of child abuse and adulthood BMI. Recent work also explores the potential role of the hypothalamic-pituitary-adrenal (HPA) axis, and other hormonal mediators such as sex-hormone binding globulin and leptin. There are also studies that suggest factors such as depression and socioeconomic and environmental influences mediate this relationship. Comorbidities that have been reported include cardiovascular and metabolic disease, diabetes, and insulin resistance. Preliminary work also demonstrates potential gender and racial disparities in the effect of abuse on adulthood obesity. In this narrative review, we summarize the existing work describing the different child maltreatment types (physical, sexual, emotional, verbal, and child neglect) and their relation to adult obesity, what is known about a potential dose-response relationship, potential mediators and pathophysiology, comorbidities, and preliminary work on gender and racial/ethnic disparities. We review the limited data on interventions that have been studied, and close with a discussion of implications and suggestions for clinicians who treat adult obesity, as well as potential future research directions., (© 2024. The Author(s).)

Purpose: Experiencing multiple adverse childhood experiences (ACEs) is associated with alcohol use in female adolescents and emerging adults. Protective and compensatory experiences (PACEs) have been theorized to off-set the health and behavioral consequences from the accumulation of ACEs throughout childhood. This study examines the association between protective experiences and subsequent alcohol and binge alcohol use frequency over one month among female adolescent and emerging adults reporting high and low levels of two ACE dimensions (household dysfunction and emotional abuse/neglect)., Methods: One hundred 43 females between the ages of 15-24 who indicated at least one binge episode in the past two weeks completed the six-item ACEs scale, the PACEs scale, and demographics at baseline. Alcohol consumption was measured prospectively over the next month during weekly appointments using the timeline follow back approach., Results: Two PACEs factors had significant direct associations, a source of unconditional love was associated with less frequent alcohol use (β = -0.437, 95% confidence interval [CI] -0.744, -0.131, exp(β) = 0.65, p = .005) in the context of high household dysfunction; and having a trusted adult to count on for help and advice (β = -1.373, 95% CI -2.283, -0.464, exp(β) = 0.25, p = .003) predicted fewer binge occasions in the context of high emotional abuse/neglect. Regardless of ACE dimension exposure, nonsport social group membership was associated more frequent alcohol use over the month across all ACE dimensions (β = 0.11-0.74, 95% CI -0.11, 0.74, exp(β) = 1.37 - 1.62, p ≤ .002); and having a trusted adult to count on for help and advice was associated with a 5.7 times more frequent of alcohol use among those with low household dysfunction (β = 1.74, 95% CI 0.83, 2.65, exp(β) = 5.70, p < .001)., Discussion: Few PACE items are associated with direct reductions in alcohol outcomes. Indeed, there is consistently heightened risk associated with nonsport group membership for alcohol use frequency, regardless of experiences of childhood adversity. Future research should identify which protective factors have the most potential to off-set alcohol use by ACE dimension., (Copyright © 2024 Society for Adolescent Health and Medicine. Published by Elsevier Inc. All rights reserved.)

Adverse childhood experiences (ACEs) contribute to numerous negative health outcomes across the life course and across generations. Here, we extend prior work by examining the association of maternal ACEs, and their interaction with financial stress and discrimination, with methylation status within eight differentially methylated regions (DMRs) in imprinted domains in newborns. ACEs, financial stress during pregnancy, and experience of discrimination were self-reported among 232 pregnant women. DNA methylation was assessed at PEG10 / SGCE, NNAT, IGF2, H19, PLAGL1 , PEG3 , MEG3-IG , and DLK1/MEG3 regulatory sequences using pyrosequencing. Using multivariable linear regression models, we found evidence to suggest that financial stress was associated with hypermethylation of MEG3-IG in non-Hispanic White newborns; discrimination was associated with hypermethylation of IGF2 and NNAT in Hispanic newborns, and with hypomethylation of PEG3 in non-Hispanic Black newborns. We also found evidence that maternal ACEs interacted with discrimination to predict offspring PLAGL1 altered DMR methylation, in addition to interactions between maternal ACEs score and discrimination predicting H19 and SGCE/PEG10 altered methylation in non-Hispanic White newborns. However, these interactions were not statistically significant after multiple testing corrections. Findings from this study suggest that maternal ACEs, discrimination, and financial stress are associated with newborn aberrant methylation in imprinted gene regions.

A systematic literature review and meta-analysis was performed to evaluate the effects of dapagliflozin on low-density lipoprotein (LDL) cholesterol in type 2 diabetes mellitus. Data on changes in LDL cholesterol, adverse cardiac events (ACEs), glycated hemoglobin (HbA1c), and fasting blood glucose (FBG) were pooled in a meta-analysis. Data from dose comparison trials were separately pooled, and meta-analysis was conducted by using RevMan (5.4.1) and R (4.1.2). Dapagliflozin increased LDL cholesterol by 2.33 mg/dL (95% CI, 1.46 to 3.19; I 2 = 0%; P < .00001), increased risk of ACEs by 1.56 (95% CI, 1.02 to 2.39; I 2 = 0%; P < .04), decreased HbA1c by -0.41% (95% CI, -0.44 to -0.39; I 2 = 85%; P < .00001), and decreased FBG by -13.51 mg/dL (95% CI, -14.43 to -12.59; I 2 = 92%; P < .00001) versus any placebo or active comparator. Dapagliflozin 10 mg monotherapy increased LDL cholesterol by 1.71 mg/dL (95% CI, -1.20 to 4.62; I 2 = 53%; P = .25) versus a 5 mg dose and by 1.04 mg/dL (95% CI, -1.17 to 3.26; I 2 = 62%; P = .36) versus a 2.5 mg dose. Dapagliflozin 10 mg monotherapy increased LDL cholesterol by 3.13 mg/dL (95% CI, 1.31 to 4.95; I 2 = 0%; P = .0008), increased the risk of ACEs by 1.26 (95% CI, 0.56 to 2.87; I 2 = 0%; P = .58), decreased HbA1c by -0.4% (95% CI, -0.45 to -0.35; I 2 = 89%; P < .00001), and decreased FBG by -8.39 mg/dL (95% CI, -10 to -6.77; I 2 = 96%; P < .00001) versus a placebo or active comparator. Dapagliflozin monotherapy resulted in a minimal but statistically significantly (P = .0002) increase in LDL cholesterol. However, this minor change does not increase the risk of ACEs (P = .17) when compared with placebo or active comparator., (© 2024, The American College of Clinical Pharmacology.)

Background: Adverse childhood experiences (ACEs) are pervasive and well-recognized as having lasting deleterious effects on the physical and mental health of those who experience them, particularly with accumulated exposure., Objective: This study seeks to identify the perspectives of interprofessional health providers on their personal and professional experiences with ACEs, ACEs screening, how to work with people with ACEs, and make recommendations for the field., Participants and Setting: Sixty-two health professionals and PhD students who completed at least one module of an online course and at least one of the accompanying discussion board sub-prompts., Methods: Responses to five course discussion board assignments, each with multiple sub-prompts, were coded to determine and refine major themes and merged with demographic and other background data. From the 561 responses, six themes were identified and used to analyze response patterns., Results: Twenty-nine percent of responses reflected a macro perspective on ACEs; 29 % of responses reflected workplace experiences; 28 % of responses reflected ACEs complexity, 8 % of responses reflected a personal relationship to ACEs, 3 % reflected perspectives on resilience; and 3 % were related to the course. Participants communicated complex understandings of ACEs, demonstrating the relevance and importance of the topic for public health training., Conclusions: Integrating ACEs training into the practice setting provides opportunities to improve the health and lives of those suffering from ACEs, especially when incorporating provider voice and perspectives., Competing Interests: Declaration of competing interest None., (Copyright © 2024 The Author(s). Published by Elsevier Ltd.. All rights reserved.)

Background: Adolescents exposed to adversity show higher levels of depression and anxiety, with the strongest links seen in socially/societally disadvantaged individuals (e.g., females, low socioeconomic status [SES]), as well as neurodivergent individuals. The intersection of these characteristics may be important for the differential distribution of adversity and mental health problems, though limited findings pertain to the extent to which intersectional effects moderate this association., Methods: Combined depression/anxiety symptoms were measured using the emotional problems subscale of the Strengths and Difficulties Questionnaire in 13-14-year-olds in Cornwall, United Kingdom in 2017-2019. In a cross-sectional design (N = 11,707), multiple group structural equation modeling was used to estimate the effects of youth adversity on depression/anxiety symptoms across eight intersectionality profiles (based on gender [female/male], SES [lower/higher], and traits of hyperactivity/inattention [high/low]). Moderation effects of these characteristics and their intersections were estimated., Results: Youth adversity was associated with higher levels of depression/anxiety (compared to an absence of youth adversity), across intersectional profiles. This effect was moderated by gender (stronger in males; β = 0.22 [0.11, 0.36]), and SES (stronger in higher SES; β = 0.26 [0.14,0.40]); with indications of moderation attributable to the intersection between gender and hyperactivity/inattention (β = 0.21 [-0.02,0.44])., Conclusions: Youth adversity is associated with heightened depression/anxiety across intersectional profiles in 13-14-year-olds. The stronger effects observed for males, and for higher SES, may be interpreted in terms of structural privilege. Preliminary findings suggest that vulnerability and resilience to the effects of youth adversity may partially depend on specific intersectional effects. Importantly, the current results invite further investigation in this emerging line of inquiry., (© 2024 The Authors. Journal of Adolescence published by Wiley Periodicals LLC on behalf of Foundation for Professionals in Services to Adolescents.)

The current study aimed to understand the effects of adverse childhood experiences (ACEs) and cultural factors on Latinx parents' tobacco use. Tobacco use is the leading cause of death among Latinx individuals in the USA, and parental use has long-term secondary harm for children. Thus, it is important to examine cultural protective factors that could prevent Latinx parents and children from the negative health effects of tobacco use. Data came from 2813 18- to 50-year-old Latinx respondents who participated in the Wave 3 of the National Epidemiological Survey on Alcohol and Related Conditions. They reported having children living in their household and had complete data for the variables of interest. In this sample (mean age = 33.5 years, 53.7% female), 16.4% (95%CI = 14.7%, 18.4%) and 7.4% (95%CI = 6.4%, 8.6%) were current and former smokers, respectively. The multivariate multinomial logistic regression analysis showed that experiencing more ACEs categories was associated with increased likelihood of current and former tobacco use compared to never use. Past year discrimination experiences and being US born (2nd and 3rd-generation parents) also increased the likelihood of current use. Differences in risk of current and former tobacco use were found based on respondents' country of origin, with protection against tobacco use found for most countries compared to being from Puerto Rico. Stronger ethnic-racial identity was not protective against tobacco use. Findings show the importance of considering ACEs and cultural factors when designing and implementing tobacco cessation programs for Latinx parents and increasing awareness of the impact of parents' tobacco use on their children., (© 2023. W. Montague Cobb-NMA Health Institute.)

Over the past two decades, public health research has demonstrated that Adverse Childhood Experiences (ACEs) are associated with significant and prolonged physical and mental health problems, demanding investigation into the factors that may mitigate the poor outcomes. One potential factor that may attenuate the negative impact of ACEs on individuals' health is social support. An important source of social support, both during and after adverse childhood experiences, is sibling relationships. Consequently, the purpose of the current study was to examine if two components of sibling relationships-perceived warmth and conflict-affect the relationship between ACEs and wellbeing in adulthood. A total of 439 participants ( M age = 35.06, SD  = 11.19) completed self-report measures of their ACEs, their perceived warmth and conflict with a living sibling, and their wellbeing. Results revealed that sibling relationships characterized by higher perceived warmth-and, interestingly, higher perceived conflict-attenuated the negative impact of ACEs on wellbeing in adulthood. Findings from the current study provide valuable information about how psychologist, social workers, and other health professionals may use siblings as a source of social support to mitigate the negative effects of ACEs on wellbeing in adulthood.

The connection between adverse childhood experiences (ACEs) and anxiety disorders is well-documented. Additionally, therapy has been shown to be effective at reducing anxiety symptoms. Yet more needs to be known about how ACEs may shape the process of therapy and the trajectory of anxiety symptoms. This study was designed to compare the trajectory of improvement in anxiety symptoms over the course of 12 sessions of therapy in adults (N = 472), who reported more (greater than four) and fewer (fewer than four) ACEs using a multigroup latent growth curve analysis. Data were drawn from the Marriage and Family Therapy Practice Research Network database. Results suggested that the rate of improvement in those with more and fewer ACEs was not significantly different; however, those with more ACEs had a significantly higher average starting point of anxiety symptoms., (© 2024 American Association for Marriage and Family Therapy.)

Background: Empirical studies have demonstrated associations between ten original adverse childhood experiences (ACEs) and multiple health outcomes. Identifying expanded ACEs can capture the burden of other childhood adversities that may have important health implications., Objective: We sought to identify childhood adversities that warrant consideration as expanded ACEs. We hypothesized that experiencing expanded and original ACEs would be associated with poorer adult health outcomes compared to experiencing original ACEs alone., Participants: The 11,545 respondents of the National Longitudinal Surveys (NLS) and Child and Young Adult Survey were 48.9 % female, 22.7 % Black, 15.8 % Hispanic, 36.1 % White, 1.7 % Asian/Native Hawaiian/Pacific Islander/Native American/Native Alaskan, and 7.5 % Other., Methods: This study used regression trees and generalized linear models to identify if/which expanded ACEs interacted with original ACEs in association with six health outcomes., Results: Four expanded ACEs-basic needs instability, lack of parental love and affection, community stressors, and mother's experience with physical abuse during childhood -significantly interacted with general health, depressive symptom severity, anxiety symptom severity, and violent crime victimization in adulthood (all p-values <0.005). Basic needs instability and/or lack of parental love and affection emerged as correlates across multiple outcomes. Experiencing lack of parental love and affection and original ACEs was associated with greater anxiety symptoms (p = 0.022)., Conclusions: This is the first study to use supervised machine learning to investigate interaction effects among original ACEs and expanded ACEs. Two expanded ACEs emerged as predictors for three adult health outcomes and warrant further consideration in ACEs assessments., (Copyright © 2024 Elsevier Ltd. All rights reserved.)

Objective: This study explicates the relationship between college student's adverse childhood experiences (ACEs) and their anticipated engagement in five types of risky behaviors. Two transdiagnostic mechanisms were tested cross-sectionally: disconnection/rejection early maladaptive schemas (cognitive) and difficulties in emotional regulation (emotional). Participants: 521 college student participants were majority female (66.8%), White (57.2%), freshman (54.9%), and heterosexual (72.2%). Methods: Participants completed an online, self-report, survey. Pearson bivariate correlations and parallel mediation analyses were conducted. Results: Sixty percent of students endorsed at least one ACE. Among the total sample, disconnection/rejection schemas partially mediated the relationship between ACEs and anticipated engagement in irresponsible academic/work behaviors, drug use, aggressive/illegal activities, and heavy drinking. Difficulties in emotion regulation partially mediated anticipated risky sexual activities and irresponsible academic/work behaviors. Sex differences were noted. Conclusions: Preventing irresponsible academic activity and other risky behaviors is critically important to college students, parents, and administrators. Intervention efforts should address cognitive and emotional mechanisms.

Background: Investigations have shown the different impacts that ACEs have on an individual's adult life, on both physical and mental health, but they have not yet shown the issue of the influence of ACEs on adults and young adults. Objective/Participants and Setting: This systematic review, performed according to the PRISMA norms and guidelines, intended to understand the most frequent outcomes of adverse childhood experiences in the life of young adults and adults., Methods: Studies were identified through multiple literature search databases at EBSCOhost, Web of Science, and PubMed April 2023, and a total of 279 studies, published between 1999 and 2002, were excluded, 256 because of multiple factors: being duplicates, showing statistical analysis with correlations only, being systematic reviews or case studies, comprising individuals under the age of 18, and not meeting the intended theme; ultimately, we selected for the review a total of 23 studies., Results and Conclusions: The impacts of the various articles are subdivided into three main themes: antisocial and criminal behaviour; sexual Behaviour and intimate partner violence; and attachment, quality of life, and therapeutic alliance.

Background: The long-lasting influence of childhood adversity on mental health is well documented; however empirical research examining how this association extends into older adults is limited. This study operationalises adversity using cumulative risk and latent class analysis (LCA) models to assess how adversity exposure and typologies may predict anxiety and depression in older adults., Methods: Data came from the Personality and Total Health (PATH) Through Life Project (N = 2551, age 60-66). Participants retrospectively reported their childhood experiences of domestic adversity on a 17-item scale. Mental health was measured using four validated questionnaires of depression and anxiety., Results: Linear and generalised additive models (GAM) indicated a dose-response relationship, where a greater number of cumulative adversities were associated with poorer scores on all four mental health measures. LCA identified a four-class solution; with high adversity and high parental dysfunction being associated with poorer mental health outcomes while moderate parental dysfunction and low adversity groups scored at healthy levels. Women reported higher overall anxiety than men, but no notable interactions between ACEs and gender were observed. Patterns revealed by LCA were similar to patterns shown by the cumulative risk model., Limitations: There is a large time gap from childhood to assessment, making our study susceptible to recall bias. Also, our findings were based on cross-sectional data, limiting causal inferences., Conclusion: Childhood adversity had independent and additive contributions to depression and anxiety in older adulthood, and both cumulative risk and person-centred approaches captured this relationship., Competing Interests: Declaration of competing interest The authors have reported no conflicts of interest., (Copyright © 2024 The Author(s). Published by Elsevier B.V. All rights reserved.)

Multiracial people report higher mean Adverse Childhood Experiences (ACEs) scores and prevalence of anxiety than other racial groups. Studies using statistical interactions to estimate racial differences in ACEs-anxiety associations do not show stronger associations for Multiracial people. Using data from Waves 1 (1995-97) through 4 (2008-09) of the National Longitudinal Study of Adolescent to Adult Health (Add Health), we simulated a stochastic intervention over 1,000 resampled datasets to estimate the race-specific cases averted per 1,000 of anxiety if all racial groups had the same exposure distribution of ACEs as Whites. Simulated cases averted were greatest for the Multiracial group, (median = -4.17 cases per 1,000, 95% CI: -7.42, -1.86). The model also predicted smaller risk reductions for Black participants (-0.76, 95% CI: -1.53, -0.19). CIs around estimates for other racial groups included the null. An intervention to reduce racial disparities in exposure to ACEs could help reduce the inequitable burden of anxiety on the Multiracial population. Stochastic methods support consequentialist approaches to racial health equity, and can encourage greater dialogue between public health researchers, policymakers, and practitioners., (© The Author(s) 2024. Published by Oxford University Press on behalf of the Johns Hopkins Bloomberg School of Public Health. All rights reserved. For permissions, please e-mail: journals.permissions@oup.com.)

Background: Adverse childhood experiences (ACEs) refer to distressing events before age 18 that can lead to potential mental and physical health consequences. This systematic review and meta-analysis aimed to examine the association between ACEs and the risk of dementia in elderly adults who experienced ACEs during childhood, addressing the existing inconsistencies and methodological variations., Methods: A comprehensive search strategy was employed across key databases (PubMed, Web of Science, Scopus, and Embase) to identify relevant articles. Our primary outcome was ACEs-dementia risk, and our secondary outcome was mild cognitive impairment risk. A quality assessment was conducted using the Newcastle-Ottawa Quality Assessment Scale and GRADE. A random-effects model was utilized to calculate pooled odds ratios (ORs) and 95% confidence intervals (CIs). Subgroup analyses were performed to explore potential sources of heterogeneity and assess the reliability of the results., Results: Out of 1,376 screened papers, nine studies were included. The studies consisted of two case-control, one prospective cohort, and six retrospective cohort studies conducted in the UK, France, USA, China, and Spain. Five studies were of good methodological quality according to the NOS. according to the GRADE, all outcomes were classified as very low or low quality of evidence. A significant association was observed between ACEs and dementia risk (OR = 1.35; 95% CI 1.20, 1.52; P = 0.00001) and mild cognitive impairment risk (OR = 1.28; 95% CI 0.63, 2.62; P = 0.49). A meta-analysis by type of adversity revealed significant results for the maltreatment subgroup(OR = 1.30; 95% CI 0.07-1.58; P = 0.007; I² = 0%). Subgroup analysis based on the dementia definition revealed no between-subgroup difference (P = 0.71) between tool-based and register/criteria-based subgroups. No possibility of Publication bias was observed upon inspection of the funnel plot., Conclusion: Adverse childhood experiences may be associated with an increased risk of dementia. However, caution is warranted in interpreting these results due to the limited number of studies. Larger high-quality studies investigating the association between ACEs and dementia risk are needed to confirm the reliability of our results., (© 2024. The Author(s).)

Aim: To propose a framework for consistently applying the 2018 periodontal status classification scheme to epidemiological surveys (Application of the 2018 periodontal status Classification to Epidemiological Survey data, ACES)., Proposed Framework: We specified data requirements and workflows for either completed or planned epidemiological surveys, utilizing commonly collected measures of periodontal status (clinical attachment levels [CAL], probing depths, bleeding on probing), as well as additional necessary variables for the implementation of the 2018 periodontal status classification (tooth loss due to periodontitis and complexity factors). Following detailed instructions and flowcharts, survey participants are classified as having periodontal health, gingivitis or periodontitis. Rates of edentulism must also be reported. In cases of periodontitis, instructions on how to compute the stage and extent are provided. Assessment of grade can be derived from CAL measurements (or from radiographic alveolar bone loss data) in relation to root length and the participant's age., Conclusions: ACES is a framework to be used in epidemiological studies of periodontal status that (i) have been completed, and in which stage and grade according to the 2018 classification are inferred retroactively, or (ii) are being planned. Consistent use of the proposed comprehensive approach will facilitate the comparability of periodontitis prevalence estimates across studies., (© 2024 The Authors. Journal of Clinical Periodontology published by John Wiley & Sons Ltd.)

This article explores how South Australian judges use information about child sexual abuse (CSA) victimization history and its potentially traumatic impact, when sentencing adult defendants. Past research indicates that sentencing outcomes may significantly improve if judicial officers are "trauma-informed." "Trauma" is the distressing impact of adversity on an individual's social and emotional well-being. Drawing from a sample of 33 sentencing remarks within which judicial officers have identified defendants with histories of CSA, this article applies a trauma-informed practice framework to explore the degree to which the sentencing of these defendants may be trauma-informed. Finally, the paper discusses potential initiatives to better achieve community safety when sentencing people with trauma from CSA. The findings are highly transferable, given the parallels in the sentencing calculus across countries that have a Westminster system of law.

The prevalence of mental health problems among young adults is widely recognized. However, limited research has examined the mental health of Arab American young adults specifically. To address this gap in the literature, this study aimed to investigate the effects of multiple stressors including adverse childhood experiences (ACEs), discrimination, and bullying victimization on the mental health of first- and second-generation Arab American young adults. The participants (N = 162) were recruited from a Midwest university using online and in-person methods. They were screened and completed a demographic questionnaire and self-report measures of ACEs, discrimination, bullying victimization, and mental health. Hierarchical multiple regression analysis was conducted to examine the effect of psychosocial stressors on mental health and the moderating effect of generation (first vs. second) on that relationship. Female gender, increased perceived discrimination, and more ACEs were associated with lower mental health scores (β = -0.316, p < 0.001, β = -0.308, p < 0.001, and β = -0.230, p = 0.002, respectively). There was a significant negative relationship between victimization and mental health for first-generation Arab Americans (β = -0.356, p = 0.010). However, that association all but disappeared for second-generation participants (β = 0.006, p = 0.953). The results highlight the impact of multiple adversities on Arab American young adults' mental health and indicate important nuances related to their generation in the association between bullying victimization and mental health. Implications for practice and future research are discussed., (© 2023 Wiley Periodicals LLC.)

Background: Adverse Childhood Experiences (ACEs) are associated with poor mental health outcomes and risk-taking behaviors. Positive childhood experiences (PCEs) may mitigate these negative impacts., Objective: This study 1) assessed the associations between ACEs and negative health outcomes and risk-taking behaviors among young adults, and 2) evaluated whether - and which - PCEs moderate the association between ACEs and these outcomes in sub-Saharan Africa., Methods: This multi-country analysis combined cross-sectional representative survey data from young adults, ages 18-24 years, from the 2019 Kenya, 2018 Lesotho, 2019 Mozambique, and 2019 Namibia Violence Against Children and Youth Surveys. The association between experiencing any ACEs and each health outcome was assessed using Wald's chi-square tests. Multivariable logistic regression analyses assessed the association between each PCE and each outcome of interest., Results: Females who experienced any ACEs had higher odds of experiencing moderate to severe mental distress (aOR = 2.7, 95%CI: 1.9, 3.9). Males who experienced any ACEs had higher odds of experiencing suicidal/self-harm behaviors (aOR = 6.7, 95%CI: 2.8, 16.0) and substance use (aOR = 2.5, 95%CI: 1.4, 4.2). In females, strong mother-child relationship was protective against moderate to severe mental distress (aOR = 0.7, 95%CI: 0.6, 0.9), suicidal/self-harm behaviors (aOR = 0.6, 95%CI: 0.4, 0.9), and substance use (aOR = 0.6, 95%CI: 0.4, 0.9). For males, a strong mother-child relationship was protective against suicidal/self-harm behaviors (aOR = 0.5, 95%CI: 0.2, 0.9), and a strong father-child relationship was protective against suicidal/self-harm behaviors (aOR = 0.4, 95%CI: 0.2, 0.7) and substance use (aOR = 0.6, 95%CI: 0.4, 0.8)., Conclusions: Strong parenting programs may likely play an important role in improving the psychosocial health of young adults., Competing Interests: Declaration of competing interest There are no conflicts of interest to disclose, and no funding was received for this work., (Copyright © 2023. Published by Elsevier Ltd.)

Background: Adverse childhood experiences (ACEs) have been understudied in low- and middle-income countries, especially in sub-Saharan Africa., Objectives, Participants, Setting: We explored associations between mental distress, self-harm or suicidality, and HIV risk and individual and cumulative ACEs (sexual, emotional, and physical violence; witnessing community and interparental violence; orphanhood) among youth aged 13-24 in Lesotho., Methods: Multivariable logistic regressions stratified by sex using nationally representative 2018 Lesotho Violence Against Children and Youth Survey (n female  = 7101; n male  = 1467) data., Results: Over 75 % of males and females experienced at least 1 ACE. Among males, physical and community violence were significantly associated with mental distress; orphan status and emotional violence was associated with self-harm/suicidality. Males who witnessed interparental violence had higher odds of disclosing 2 types and 3 or more types of HIV risk versus none. Among females, being a double orphan and having experienced sexual, emotional, physical, community, and interparental violence were significantly associated with mental distress and any self-harm/suicidality in both models. Females who experienced physical violence had higher odds of disclosing 3 or more risk types versus no risk. Statistically significant associations emerged between cumulative ACEs and mental distress, self-harm/suicidality, and higher levels of HIV risk for both males and females., Conclusions: Differential patterns of associations between ACEs and mental health problems and HIV risk emerged by sex. Scalable, integrated individual and community efforts to prevent ACEs, provide mental health supports, and encourage safer sexual behaviors among those exposed are needed and could benefit youth in Lesotho., (Copyright © 2024 Elsevier Ltd. All rights reserved.)

Contextual risk factors, such as adverse childhood experiences (ACEs), have a significant impact on the mental health of Black youth. Surprisingly, few studies focus efforts specifically on Black youth. The present study investigates the influence of ACEs on psychological distress among Black youth. Additionally, guided by social cognitive theory, this study highlights emotional self-control as a protective mechanism against the negative consequences of ACEs. Our findings show that ACEs (T1) predicted psychological distress among Black youth a year later (T2). Emotional self-control emerged as a significant buffer of ACEs on the association with psychological distress. Thus, to prevent negative mental health outcomes for Black youth, it is imperative to focus prevention efforts on the crucial risk factors that affect healthy development. By working to increase emotional self-control among Black youth who suffered adverse childhood experiences, negative mental health outcomes over time can be reduced., (© The Author(s), under exclusive licence to Springer Nature Switzerland AG 2024. Springer Nature or its licensor (e.g. a society or other partner) holds exclusive rights to this article under a publishing agreement with the author(s) or other rightsholder(s); author self-archiving of the accepted manuscript version of this article is solely governed by the terms of such publishing agreement and applicable law.)

Introduction: Experiences of violence among people living with HIV (PLWH) are thought to be highly prevalent but remain inadequately captured. As a first step toward acceptable, trauma informed practices that improve engagement and retention in care for PLWH, we must acquire more comprehensive understanding of violence experiences. We examined experiences of various forms of lifetime violence: adverse childhood experiences (ACES), intimate partner violence (IPV), non-partner violence (NPV), and hate crimes among diverse sample of PLWH in Atlanta, Georgia., Methods: Cross sectional data collected from in- and out-of-care PLWH ( N = 285) receiving care/support from Ryan White Clinics (RWCs), AIDS Service Organizations (ASOs), or large safety-net hospital, February 2021-December 2022. As part of larger study, participants completed interviewer-administered survey and reported on experiences of violence, both lifetime and past year. Participant characteristics and select HIV-related variables were collected to further describe the sample. Univariate and bivariate analyses assessed participant characteristics across types of violence., Results: High prevalence of past violence experiences across all types (ACES: 100%, IPV: 88.7%, NPV: 97.5%, lifetime hate crimes 93.2%). People assigned male at birth who identified as men experienced more violence than women, with exception of non-partner forced sex. Participants identifying as gay men were more likely to have experienced violence., Conclusion: Among our sample of PLWH at the epicenter of the United States HIV epidemic, histories of interpersonal and community violence are common. Findings emphasize need for RWCs, ASOs, and hospital systems to be universally trained in trauma-informed approaches and have integrated onsite mental health and social support services., Competing Interests: The authors declare that the research was conducted in the absence of any commercial or financial relationships that could be construed as a potential conflict of interest., (Copyright © 2024 Sales, Anderson, Livingston, Garbarino, Hadera, Rose, Carlson and Kalokhe.)

Unhoused children and adolescents have high rates of adverse childhood experiences (ACEs). The objective of this study was to characterize a large cohort of unhoused children and investigate rates of psychiatric diagnoses, medical diagnoses, and utilization of emergency department (ED) resources depending on the presence of additional documented ACEs. A retrospective cohort of all unhoused children who presented to the ED of a large Midwestern health system from January 2014 to July 2019 were included. Unhoused status was determined by address field or ICD-10 code for homelessness (Z59.0). Demographics and ED visits were extracted from the electronic health record. Past medical history, ACEs, chief complaint (CC), length of stay (LOS), imaging, and labs were extracted by chart review. T-tests, chi square tests, and Fisher's exact tests were completed for each sub-analysis. Unhoused children with at least one additional ACE had higher odds of the following psychiatric disorders: depression (OR = 5.2, 95% CI = 3.4- 7.9), anxiety (OR = 3.4, 95% CI = 32.1-5.5), behavioral disorder (OR = 7.2, 95% CI = 35.1- 10.4), psychoses (OR = 6.0, 1.9-18.4), bipolar disorder (OR = 19.8, 95% CI = 34.6-84.9), suicidal ideation (OR = 8.0, 95% CI = 34.8-13.4), post-traumatic stress disorder (OR = 10.1, 95% CI = 35.4-18.6), and attention deficit hyperactive disorder (OR = 4.1, 3.0-5.7). Patients with additional documented ACEs were also more likely to have a prior psychiatric admission (p < 0.001). Unhoused children and adolescents with exposure to additional documented ACEs are more likely to have some serious psychiatric and medical diagnoses compared to other unhoused children., Competing Interests: Conflicts of InterestOn behalf of all authors, the corresponding author states that there is no conflict of interest., (© The Author(s), under exclusive licence to Springer Nature Switzerland AG 2024. Springer Nature or its licensor (e.g. a society or other partner) holds exclusive rights to this article under a publishing agreement with the author(s) or other rightsholder(s); author self-archiving of the accepted manuscript version of this article is solely governed by the terms of such publishing agreement and applicable law.)

Background: Despite facing challenges to mental wellness from ongoing multifold trauma, Indigenous youth continue to galvanize their resilience. One pathway undertaken is embracing technology. The JoyPop™ youth resilience mobile application (app) was invited by Six Nations of the Grand River (SN) leadership to consider its use with their reserve youth., Objective: This study explored the feasibility of JoyPop™ research from the SN community adult perspective for appropriateness and relevance to SN youth, as a precursor to a user-experience study with community youth., Methods: Semi-structured, online interviews with 19 adult community members (26 % male) about JoyPop™ were conducted with nominated stakeholders from SN. Based on a standard presentation of the app, comments were solicited about app features, design, and relevance to Haudenosaunee culture. Interviews were transcribed, coded in a double-blind fashion, and analyzed for themes., Results: Most offered positive feedback, with some level of support for each feature of JoyPop™. Themes were identified (Need for Indigenous Design, Incorporation of Indigenous Culture, Appreciation of Ease, Flexibility and Personalization), stemming from comments of appraisal and suggestions for adaptations (e.g., incorporating more cultural elements, localized resources, simplification of app)., Conclusions: The JoyPop™ app was viewed as positive and relevant, based on feedback from adults within SN. Adaptations were identified by adults to better fit SN youth needs, and research with SN youth is pending before implementation of adaptations. Research with other communities is encouraged to expand the reach of technology interventions, to holistically support Indigenous youth mental health in a culturally relevant way., Competing Interests: Declaration of competing interest The authors declare that they have no known competing financial interests or personal relationships that could have appeared to influence the work reported in this paper., (Copyright © 2023 Elsevier Ltd. All rights reserved.)

Objective: Adverse childhood experiences (ACEs) are early life experiences that influence mental health outcomes, though there are mixed findings reported in relation to attention deficit hyperactivity disorder (ADHD) symptoms. The current study compared adults who experienced ACEs on measures of ADHD symptom reporting, psychological symptoms, and neurocognitive test performance., Method: The sample ( n  = 115) had mean age of 28.42 ( SD  = 6.46); educational attainment of 16.47 years ( SD  = 1.99); and was 35% male/65% female and racially/ethnically diverse. Participants completed measures of ACEs, ADHD symptoms, psychopathology, and perceived stress, as well as neuropsychological tests., Results: The high ACEs group endorsed higher levels of childhood/adulthood inattentive, impulsive, and hyperactive symptoms, and overall childhood symptoms when compared to the low ACEs group., Conclusions: This study provides a more comprehensive understanding of the association between ACEs and cognitive/mental health outcomes. Greater ACEs resulted in higher ADHD symptom reporting but not significantly greater psychological symptoms or worse neurocognitive performance., Competing Interests: Declaration of Conflicting InterestsThe author(s) declared no potential conflicts of interest with respect to the research, authorship, and/or publication of this article.

Adverse Childhood Experiences (ACEs) confer considerable risk for negative outcomes across the lifespan, but there is limited research examining whether the measurement of ACEs can be interpreted the same way across diverse groups of individuals. In particular, the measurement of ACEs among early child education teachers has received little attention. Given that millions of children receive care from early child education teachers, and evidence that ACEs can severely disrupt teacher's abilities to support young children, it is critical to accurately assess for and respond to teacher ACEs. The present study examined the factor structure and measurement invariance of the 11-item Behavioral Risk Factor Surveillance Survey (BRFSS) version of the ACEs measure across a diverse group of teachers. Data were collected from 605 teachers in a southeastern state between 2018 and 2021. Teachers ranged in age from 18 to 81 years (35% young; 56% middle; and 9% older adults) and were diverse across race (46% White; 53% Black). Teachers completed the BRFSS version of the ACEs measure and a demographics questionnaire. Factor analyses replicated the theorized three-factor solution, with household dysfunction, emotional/psychological abuse, and sexual abuse emerging as distinct factors. Multigroup confirmatory factor analyses demonstrated measurement invariance across teacher age and race. Comparisons of scores indicated ACEs levels varied across teacher age and race. Overall, findings suggest the BRFSS version of the ACEs measure can be used to assess adverse childhood experiences across diverse groups of early child education teachers., Competing Interests: Disclosure of Interest All authors declare that they have no conflicts to report.

Objectives: Adverse childhood experiences (ACEs) and anxiety-depression co-morbidity are attracting widespread attention. Previous studies have shown the relationship between individual psychiatric disorders and ACEs. This study will analyze the correlation between anxiety-depression co-morbidity and different levels of ACEs., Methods: Seven categories of ACE and four classifications of psychiatric disorders were defined in a sample of 126,064 participants identified by the UK Biobank from 2006-2022, and correlations were investigated using logistic regression models. Then, to explore nonlinear relationships, restricted spline models were developed to examine differences in sex and age across cohorts ( n  = 126,064 for the full cohort and n  = 121,934 for the European cohort). Finally, the impact of the category of ACEs on psychiatric disorders was examined., Results: After controlling for confounders, ACEs scores showed dose-dependent relationships with depression, anxiety, anxiety-depression co-morbidity, and at least one (any of the first three outcomes) in all models. ACEs with different scores were significantly positively correlated with the four psychiatric disorders classifications, with the highest odds of anxiety-depression co-morbidity (odds ratio [OR] = 4.87, 95% confidence intervals [CI]: 4.37 ~ 5.43), p = 6.08 × 10 -178 . In the restricted cubic spline models, the risk was relatively flat for females at ACEs = 0-1 and males at ACEs = 0-2/3 (except in males, where ACEs were associated with a lower risk of anxiety, all other psychiatric disorders had an increased risk of morbidity after risk smoothing). In addition, the risk of having anxiety, depression, anxiety-depression co-morbidity, and at least one of these disorders varies with each category of ACEs., Conclusion: The prevalence of anxiety-depression comorbidity was highest across ACE scores after controlling for confounding factors and had a significant effect on each category of ACEs., Competing Interests: The authors declare that the research was conducted in the absence of any commercial or financial relationships that could be construed as a potential conflict of interest., (Copyright © 2023 Yu, Jiang, Zheng, Zeng, Huang, Jin and Wang.)

There is limited existing research on whether specific combinations of Adverse Childhood Experiences (ACEs) are associated with different psychiatric disorders among adolescents with ADHD. This study aimed to address this gap by identifying classes of ACEs and examining their association with behavioral problems, anxiety, and depression in adolescents with ADHD aged 11-17 (n = 1,806), using data from the 2018 National Survey of Children's Health (NSCH). A latent class analysis revealed a four-class solution: (1) low-risk ACEs (61.6%), (2) moderate-risk ACEs (25.2%), (3) high discrimination and neighborhood violence exposure (7.6%), and (4) high-risk ACEs (5.6%). The "high-risk ACEs" and the "high discrimination and neighborhood violence exposure" class showed a higher likelihood of behavioral problems and depression, and anxiety and depression respectively. These findings provide some insight into the ACE patterns that are more likely to be associated with mental health problems among adolescents with ADHD., (© 2023. The Author(s), under exclusive licence to Springer Science+Business Media, LLC, part of Springer Nature.)

Background: Research has consistently found poorer outcomes in adolescents who have been exposed to early interpersonal adversities, especially those in out-of-home placements. The presence of mental health problems also contributes to the perception of a more negative group climate and peer interactions through cascading effects., Objective: To analyze the sequential relationships between exposure to adverse childhood experiences (ACEs), trauma-related symptoms, psychological maladjustment, and the perception of group climate and peer interactions. In addition, the study analyzes the mediating role of trauma-related symptoms and psychological maladjustment., Participants and Setting: The sample comprised 161 adolescents in out-of-home care (46.6 % males, 49.7 % females, 3.7 % non-binary), aged 12-18 (M = 15.22, SD = 1.59) from 24 residential facilities in Spain., Methods: This study is part of the VRINEP project. Group care workers reported about ACEs and trauma-related symptoms through online questionnaires, whereas adolescents self-reported about psychological maladjustment, group climate, and peer interactions., Results: Differential associations between ACEs with trauma-related symptoms and internalizing problems were found. The relationship between certain ACEs and externalizing problems was fully mediated by trauma-related symptoms. Likewise, psychological maladjustment was related to a more negative perception of the group climate and peer interactions. Although trauma-related symptoms were not directly associated with the perception of the residential environment, they were indirectly associated with peer relational aggression through externalizing problems., Conclusions: Mental health has a significant impact on the perception of the group climate and peer interactions among adolescents in residential care who have been exposed to ACEs., (Copyright © 2023 Elsevier Ltd. All rights reserved.)

Background: The relationship between adverse childhood experiences and sleep disturbances in collegiate athletes was examined., Methods: A questionnaire was completed by 189 National Collegiate Athletic Association (NCAA) Division-I male (n = 102) and female (n = 87) student-athletes recruited by flyers on one campus. Variables included adverse childhood experiences (self-reported), insomnia (Insomnia Severity Index), sleep quality (Pittsburgh Sleep Quality Index), fatigue (Fatigue Severity Scale), and sleep duration (self-reported). In relation to these variables, eight adverse childhood experience categories were examined. Linear regression adjusted for the effects of age and sex. Adverse childhood experience variables were explored as independent variables in separate and combined models., Results: We found a statistically significant dose-response relationship between adverse childhood experience score and increased insomnia levels, poor sleep quality and decreased sleep duration (p < .05). Physical abuse was associated with increased fatigue (B=9.55, p = .017) and decreased sleep duration (B=-61.1, p = .017). Emotional neglect was associated with increased insomnia (B=5.82, p < .0005), decreased sleep quality (B=3.55, p = .001), fatigue (B=8.68, p = .013), and decreased sleep duration (B=-86.22, p < .0005). When adjusted for other adverse childhood experience categories, emotional neglect had the strongest association with sleep outcomes, independently associated with insomnia (B=5.19, p = .003), sleep quality (B=2.95, p = .008), and sleep duration (B=-76.6, p = .001)., Conclusions: We found a significant relationship between adverse childhood experiences and adverse sleep outcomes in this sample of collegiate athletes., Competing Interests: Declaration of conflicts of interest ER has nothing to disclose. SB has nothing to disclose. AA has nothing to disclose. SG has nothing to disclose. MG reports grants from Jazz Pharmaceuticals and CeraZ, and personal fees from Fitbit, Natrol, Smartypants Vitamins, Pharmavite, Simple Habit, Athleta, Idorsia, Eisai, and Merck, outside the submitted work., (Copyright © 2023 National Sleep Foundation. Published by Elsevier Inc. All rights reserved.)

Given the high prevalence of nonsuicidal self-injury (NSSI), scientific interest is on the rise, yet its developmental course remains understudied. Factors that may influence NSSI behavior are also unclear, although early research describes it as a maladaptive form of emotion regulation. In a college student sample (N = 507), the current study examines the extent that developmental timing of, and cumulative exposure to, potentially traumatic events (PTEs) accounts for variance in NSSI frequency, duration, and desistance, as well as the role that emotion regulation difficulties (ERD) play. Of 507 participants, 411 endorsed PTE exposure and were categorized into developmental groups based on age of initial PTE exposure, with the hypothesis that initial exposure during early childhood and adolescence may represent particularly sensitive risk periods. Results revealed that cumulative PTE exposure was significantly positively associated with shorter NSSI desistance, whereas ERD were significantly negatively associated with shorter NSSI desistance. However, the interaction between cumulative PTE exposure, when coupled with current ERD significantly moderated (i.e., strengthened) the path between cumulative PTE exposure and NSSI desistance. When examined individually, this interaction was only significant for the early childhood group, suggesting that the effects of PTE exposure on NSSI persistence may vary not only as a function of emotion regulation capacities but also when in the developmental course initial PTE exposure occurs. These findings contribute to our understanding of the role of PTE and timing, as well as ERD, in predicting NSSI behavior, and can inform programs and policies to prevent and curtail self-harm., (© 2023. The Author(s), under exclusive licence to Springer Science+Business Media, LLC, part of Springer Nature.)