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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. [ABSTRACT FROM AUTHOR]

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. [ABSTRACT FROM AUTHOR]

Adverse childhood experiences (ACEs) increase youths' risk for leaving high school before graduating. However, to our knowledge, no one has examined how youth themselves conceptualize the role of ACEs in their journeys away from school. In this exploratory qualitative study, we used narrative analysis to examine (1) whether youth (n = 27) described ACEs leading them away from school, (2) how early these trajectories began, from youth's own perspectives, and (3) if this varied by elements of identity and social position. Focus groups were conducted with youth ages 18-25 from 13 communities across the U.S. We found that youth described their journeys away from school as starting with early ACEs. We also found that youths' narratives reflected intersectional gender differences in the pathways away from school that youth described. Girls articulated how ACEs influenced subsequent non-academic priorities; they eventually left or were kicked out due to a lack of credits. Boys expressed that early ACEs were followed by risk behaviors, punishment, and dropout. Implications for healing-centered engagement across settings and targeted dropout prevention are discussed. [ABSTRACT FROM AUTHOR]

This study assessed the prevalence of Adverse Childhood Experiences (ACEs) among Home Care Aides (HCAs) and explored the relationship between ACEs and mental health. A 2017 survey of 424 HCAs assessed childhood trauma using the CDC-BRFSS ACE module. Approximately 27% of HCAs had a high ACE score (between 4 and 10). There were no associations found between ACE score and respondent demographic characteristics. HCAs with high ACE scores reported lower rates of social and emotional support and higher rates of past-month hopelessness compared with those with no or limited experience of adverse childhood events. This research suggests that HCAs have higher than average rates of ACEs, known to be linked to various negative physical and mental health outcomes. [ABSTRACT FROM AUTHOR]

This study examined how adverse childhood experiences (ACEs) shape selection of college majors that commonly lead to social service jobs. Using a sample of 722 college students, this study explored differences in total ACEs and prevalence of specific ACEs among students studying social work, criminology, and human services compared with students in a non-social science field and those in other social science majors. Compared with students reporting no ACEs, students reporting four or more ACEs were more likely to study social work (RRR = 3.74, 95% CI = 1.97–7.08), criminology (RRR = 2.51, 95% CI = 1.28–4.93), or another social science (RRR = 2.88, 95% CI = 1.34–6.20) than a non-social science major. There was no significant difference in total ACEs between students studying human services and a non-social science. [ABSTRACT FROM AUTHOR]

In the 2005 Roper v. Simmons decision, the Supreme Court determined that capital punishment, the death penalty, was not appropriate for offenders under the age of 18. The Court accepted the argument that juveniles are less blameworthy than adult offenders due to differences in their cognitive abilities and the influence of factors outside of their control, such as household dysfunction or the existence of adverse childhood experiences (ACEs). Recent empirical literature examining both brain development and the impact of ACEs on both brain maturity and offending behaviors demonstrates that brain maturation and psychosocial maturation continue into the mid-twenties. As a result, youthful offenders, those 18 to 24 of age, may possess many of the neuropsychological deficiencies attributed to juveniles and yet be sentenced to death. This research examines if juries of capital punishment trials recognize the impact of age and ACEs when determining their sentencing decision. [ABSTRACT FROM AUTHOR]

Intimate partner abuse (IPA) is a public health crisis that disproportionately impacts indigenous women. We know little about rates and correlates of IPA victimization (IPAV) and abuse directed at one's partner (ADP) among indigenous women caregivers (people who take care of children). The purpose of the current study was to address this critical gap in the literature. Participants were 44 indigenous women caregivers in the United States in a current relationship who completed a survey. Most women reported IPAV and ADP experiences in the past 6 months, and IPAV and ADP abuse directed at partner were positively associated. Further, IPAV was positively associated with adverse childhood experiences (ACEs), participants' engagement in harsh parenting, and depressive symptoms. IPAV was negatively associated with age, income, indigenous cultural identity, and social support. ADP was positively associated with ACEs, harsh parenting, and depressive symptoms. ADP was negatively associated with age and income. ADP was not associated with indigenous cultural identity and social support. These data suggest the urgency with which efforts are needed to prevent and respond to IPA among indigenous women caregivers, especially those who are younger and of lower income, and that culturally grounded initiatives that seek to build social support may be especially impactful. [ABSTRACT FROM AUTHOR]

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. [ABSTRACT FROM AUTHOR]

Purpose: Examine whether barriers to physical activity (PA) and PA level serve as serial mediators to the relationship between adverse childhood experiences (ACEs) and perceived quality of physical health. Design: Cross-sectional. Setting: A public university in Southeast United States. Subjects: Seventy-five participants (18- 49 years). Measures: Self-report measures related to ACEs, barriers to PA, amount of PA, and perceived quality of physical health. Analysis: Serial mediation analysis. Barriers to PA was a first-order mediator, and PA level was a second-order mediator between ACEs and perceived quality of physical health. Results: Barriers to PA and PA levels serially mediated the relationship between ACEs and perceived quality of physical health (c = −1.01, SE =.251, P =.0002, 95% CI [−1.50, −.499]). The direct effect of ACEs on perceived quality of physical health was nonsignificant when mediators were controlled (c' = −.383, SE =.252, P =.133, 95% CI [−.886,.120]). Higher ACE scores were associated with more barriers to PA, lower PA levels, and in turn, lower perceived quality of physical health. Conclusion: The current study highlights specific pathways that contribute to the relationship between ACEs and perceived quality of physical health. Albeit limited by the sample size, preliminary data support prioritization of interventions that reduce barriers to PA when trying to increase PA in populations that are prone to early adversity. [ABSTRACT FROM AUTHOR]

Purpose: Adverse Childhood Experiences (ACE) predispose individuals to adult-onset posttraumatic stress disorder (PTSD) with amplified arousal and reactivity symptoms (A&R). This review aimed to identify interventions for reducing A&R symptoms in adults diagnosed with PTSD and a history of ACEs. Method: Systematic scoping review of RCT and quasi-experimental studies in peer-reviewed journals using Arksey and O'Malley's 5-Stage Framework. Extracted data were analyzed descriptively and thematically. Results: Five articles met inclusion criteria. Skills training in affect and interpersonal regulation (STAIR) with exposure, Cognitive Behavioral Therapy (CBT-PE), Interpersonal Processing Group Therapy (IPG), and Trauma-informed yoga interventions were identified. STAIR (d = −1.45, 95% CI [−2.10, −0.80), CBT-PE (d = −1.21, 95% CI [−1.92, −0.51]), and IPG (d = −1.33, 95% CI [−2.07, −0.58]) had large effects on A&R symptoms. Discussion: CBT exposure-based treatments were supported interventions for reducing A&R symptoms in adults diagnosed with PTSD and a history of ACEs. [ABSTRACT FROM AUTHOR]

Prior research has demonstrated that online sexual victimization (OSV) is a significant social problem and is associated with adolescents' negative developmental outcomes. However, it remains unclear whether adolescents' risky online behaviors and offline victimization are related to the risk of OSV. The present study examined whether female adolescents' risky online behaviors (mood regulation through the Internet, ingratiating behavior, disclosure of personal information, harassing behavior, talking with someone met online, and sexual behavior) and offline victimization (adverse childhood experiences [ACEs]) would be associated with OSV. This study recruited female adolescents and their mothers within six metropolitan cities and provinces of residential areas of South Korea. A total of 509 female adolescents participated in the survey (aged 13–18 years). The present study employed multivariate regression to examine the relationship of risky online behaviors and offline victimization to the experience of OSV. Female adolescents' risky online behaviors (harassing behavior, talking with someone met online, and sexual behavior) were significantly associated with OSV, and those with high exposure to maltreatment and family dysfunction during childhood were more at risk of OSV than adolescents with low exposure to ACEs. The results suggest that it is important to address the effects of risky online behaviors and exposure to offline victimization on female adolescents' sexual victimization online. Identifying risky online behaviors and offline victimization related to OSV can help researchers and practitioners further understand female adolescents' online victimizations in the context of offline and online dynamics. [ABSTRACT FROM AUTHOR]

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. [ABSTRACT FROM AUTHOR]

We examined racial/ethnic inequities in the prevalence of adverse childhood experiences (ACEs) and examined the association between ACEs and selected health-related behaviors and problems. Data for this cross-sectional study come from the 2018 Maryland Youth Risk Behavior Survey/Youth Tobacco Survey, a statewide survey of high school students (n = 40,188). ACEs included caregiver verbal abuse and household food insecurity, substance use or gambling, mental illness, and involvement with the criminal justice system. We estimated the prevalence of ACEs overall and by race/ethnicity, and then used multiple logistic regression to determine associations between ACEs and emotional/behavioral problems, adjusting for race/ethnicity. Outcome variables included emotional distress, poor school performance, suicidal ideation, fighting, alcohol use, and marijuana use. More than one fifth of students reported each individual ACE. Differences in the prevalence of ACEs by race/ethnicity were statistically significant (p <.001). More than one fourth (25.8%) reported one of the five ACEs, 15.1% reported two, and 15.4% reported three or more. For each ACE, reporting having experienced it (vs. not) was associated with a >30% higher prevalence for each of the outcome variables. Among students who reported three or more ACEs (relative to none), the odds of emotional distress and suicidal ideation were more than 8 times greater. Among Maryland adolescents, ACEs are common, are inequitably distributed by race/ethnicity, and are strongly linked to behavioral health. Findings suggest the need to monitor ACEs as a routine component of adolescent health surveillance and to refocus assessment and intervention toward "upstream" factors that shape adolescent health. [ABSTRACT FROM AUTHOR]

BACKGROUND: Service delivery organizations are advancing the provision of trauma-informed care (TIC) for youth to improve outcomes. However, currently there are no validated, reliable evaluation measures to capture the voices of adolescent clients and how well they perceive TIC implementation. AIMS: The purpose of this project was to create an evaluation measure with strong content validity for adolescent health and service users to give feedback to organizations about their implementation of TIC. This article outlines Step 1 of our instrument development, by discussing our process creating the measure and affirming content validity. Psychometric testing of this measure (Step 2) is described in a companion paper. METHODS: We combined deductive theory substruction with an inductive participatory process to create, revise, and finalize the measure. The National Center for Trauma-Informed Care's framework of four practices and six principles was substructed into an 18-item draft measure. A four-member community youth advisory board (CYAB) then worked to inductively modify our draft to provide age-appropriate clarity and ensure a nontriggering respondent experience. Finally, the CYAB members conducted cognitive interviews with 10 other adolescents in local evening data collection events, refining the measure for future psychometric testing. RESULTS: The process resulted in a 20-item form based on CYAB feedback. Refinements included providing an accessible definition of trauma, asking questions about trauma history, and asking whether trauma affected the client's visit on the day of service use. CONCLUSIONS: The CYAB involvement enhanced content validity and ensured a trauma-informed instrument development approach. [ABSTRACT FROM AUTHOR]

Adverse childhood experiences (ACEs) and social determinants of health (SDOH) negatively affect health outcomes. This program was developed to screen for ACEs and SDOH in the primary care setting in families with children 9 months to 5 years of age at well-child checks and provide interventions that support families and build resiliency. Programmatic criteria were identified, referral resources were developed, and a database was implemented, with 246 families enrolled in year 1; 56.9% of caregivers reported 1 or more ACEs for their child, 63% of caregivers reported an SDOH need, and 39.4% of caregivers reported both. The average number of ACEs was 0.94. This program was created to address ACEs and SDOH, to empower families, build resiliency, and provide buffers to mitigate and prevent ACEs. It provides a model that can be implemented in a primary care setting while providing wraparound resources, including integrated mental health resources and referrals, to measure the success of these interventions. [ABSTRACT FROM AUTHOR]

Introduction: We aimed describe the association of adverse childhood events (ACEs) with a history of substance use disorder and recent opioid use among women with chronic pelvic pain (CPP). Methods: This cohort study investigated two data sets of women presenting to subspecialty gynecologic and pelvic floor disorder clinics where questionnaires querying substance use disorder, opioid use in the last 3 months, and ACEs (BRFSS-ACE questionnaire) were obtained. We compared the recent opioid use, morphine milligram equivalents (MMEs) per dose, pills used per month, and minimum MMEs reported per month between women with high (⩾4) or low (<4) reported ACEs. Results: Patients completing the BRFSS-ACE (n = 113) were older, more likely to be Hispanic/Latina, had higher levels of education, a higher prevalence of pain syndromes, and a greater degree of bother from pelvic floor disorders than those not completing the BRFSS-ACE. Women reporting a high number of (⩾4) ACEs (n = 56) were younger, less likely to identify as Hispanic, had higher co-occurrence of fibromyalgia and IBS, and a higher prevalence of a history of substance use disorder (18% vs 2%, p < 0.01) than women with low (<4) ACEs (n = 57). High ACEs were not significantly associated with recent opioid use (43% vs 39%, p = 0.83), opioid pills used per month, MMEs per dose, or the minimum MMEs used per month. Conclusion: Women with CPP reporting higher numbers of ACEs are more likely to report a history of substance use disorder but were not more likely to have used opioids in the last 3 months. [ABSTRACT FROM AUTHOR]

Adverse Childhood Experiences (ACEs) are linked to problematic outcomes, but it remains unclear how ACEs affect developmental patterns of harmful behavior, and whether this varies by gender. This study examined these relationships among 868 youth participating in the Longitudinal Studies of Child Abuse and Neglect. Group-based trajectory models identified five trajectories of internalizing and six trajectories of externalizing outcomes. Multinomial logistic regression models examined the relationships between ACEs, gender, and the interaction between the two on trajectory group membership. Higher ACEs were associated with elevated internalizing and externalizing trajectories, and boys who experienced higher ACEs were at a heightened risk of exhibiting elevated externalizing trajectories. Findings shed light on the importance of gender in developmental responses to victimization and adversity. [ABSTRACT FROM AUTHOR]

This study examines the relationship between criminal history and adverse childhood experiences (ACEs) and how they collectively predict (a) recidivism and (b) positive social functioning among multi-problem young adults. Criminal records and self-report data regarding ACEs and adult education/employment and quality of life (QoL) were collected for 692 multiproblem young adults (18–27 years). Results indicated that an extensive criminal history was related to non-violent and violent recidivism and lack of involvement in education/employment in young adulthood. On the contrary, a higher number of ACEs was related to lower QoL later in life, while this was not associated with recidivism or education/employment. These findings highlight again that past criminal behavior is a strong predictor of future criminality, particularly within this group of young adults with multiple problems. Furthermore, experiencing negative events in childhood shows to have long-term negative effects on QoL even for these individuals who already experience multiple life problems. Implications are discussed. [ABSTRACT FROM AUTHOR]

The COVID-19 global pandemic has brought about many changes to our society, which will have long-term effects for our youth and adolescents. Due to social isolation and adverse childhood experiences, there are concerns of suicidality, technology addiction, and school safety as schools attempt to transition to a state of normalcy in the months to come. This crisis will require coordinated efforts to assist students in not only getting back on track academically but also in helping students cope with the trauma they have and are continuing to experience. As a result, insights from school counselors can be used to obtain a better understanding of the social and emotional effects of COVID-19 by collaborating with administrators to emphasize using school counselors as a mental health provider in schools. The authors highlight school counselors' mental health training and their role in combating this issue and provide practical applications that can employed to create a systemic approach for social and emotional prevention and intervention during and after the pandemic. [ABSTRACT FROM AUTHOR]

This study compared sociodemographic characteristics, adverse childhood experiences (ACEs), and substance use and psychiatric disorders between adolescent-limited (AL), adult-onset (AO), life-course-persistent (LP) and nonoffender (NO) groups using a large U.S. general population survey. The odds of experiencing several ACEs were greater among each offender group relative to NOs. LP offenders experience more ACEs than AL and AO offenders. Each offender group generally experienced greater substance use and psychopathology than NOs, whereas LP offenders experienced more substance use and psychopathology than AO and AL offenders. The results of this study identified several sociodemographic factors, ACEs, and types of psychopathology that differentiate AL, AO, LP, and NO offenders that can help inform prevention and intervention strategies designed to prevent offending and shorten criminal careers. [ABSTRACT FROM AUTHOR]

Currently, e-cigarettes are the most popular tobacco product among adolescents. The purpose of this study was to explore the relationship between exposure to adverse childhood experiences (ACEs) and use of cigarettes, e-cigarettes, and dual use in a sample of adolescents in Bangkok, Thailand. The sample comprises 6167 students from 48 schools (grades 9, 11, and vocational year 2) who participated in the 2019 round of the Behavior Surveillance Survey. History of 11 ACEs was used to calculate a cumulative ACE score (range 0-11). Multinomial logistic regression was used to assess the relationship between history of ACEs and smoking. In the sample, 7.0% reported using e-cigarettes only and 9.5% used e-cigarettes and cigarettes (dual use). After controlling for sociodemographic characteristics, history of ACEs was associated with increased odds of dual use. The odds of cigarette, e-cigarette, and dual use was significantly greater if the adolescent had a history of ≥4 ACEs. Special attention is needed to prevent smoking of different types among those with a history of ACEs. [ABSTRACT FROM AUTHOR]

Adverse Childhood Experiences (ACEs) are multiple sources of maltreatment and household dysfunction with tremendous impact on health. A trauma-informed (TI) approach is preferred when working with patients with ACEs. The Professional ACEs-Informed Training for Health© (PATH©) educational program and simulation experience using standardized patients (SP) was developed to help healthcare professionals address ACEs with adults. PATH© is a 3–4 hour curriculum comprised of lecture and discussion, video-based demonstration, simulation experience, and debriefing. It was first developed for primary care (PC) residents in family medicine and internal medicine, and subsequently modified for occupational therapy (OT) and physical therapy (PT) students. This study evaluates a preliminary dataset focusing on PATH© skills of PC residents and OT and PT students during simulation. Recordings of 53 learner-SP encounters from 15 OT and PT students and 38 PC residents were coded using standardized behavioral codes. A subset of ten recordings of PC residents who participated in simulations in the first and fourth year of the training program allowed for evaluation of training outcomes over time. Results showed that medical residents and OT and PT students demonstrated skills during SP encounters congruent with TI training on addressing ACEs with adults, particularly in explaining ACEs, demonstrating empathy, collaborative treatment planning, and stigma reduction. PC residents showed both positive and negative changes in PATH©-specific skills from year 1 to 4 of the training program. This study supports the PATH© model and simulation-based training in preparing clinicians to address ACEs with adults and provides insight into further curriculum improvement. [ABSTRACT FROM AUTHOR]

Objective: The primary care office is an ideal setting to identify and address adverse childhood experiences, which is a strong predictor of chronic health outcomes and morbidity. This study sought to understand the experiences of primary care from the perspective of patients who experienced trauma. Method: Purposive sampling was used to select eligible and interested participants who identify a high adverse childhood experience score at a residency-based community health center, which offers integrated behavioral health services in primary care. Semistructured in-depth interviews conducted by doctoral-level behavioral health clinicians were audio-recorded, transcribed, and analyzed thematically. Results: Subjects (n = 6) described aspects of medical setting, including removal of clothing or physical touch, that trigger their past trauma, which often resulted in maladaptive stress responses. Subjects also reported sensing when their complexity resulted in negative interpersonal dynamics between team members, and they described fearing abandonment from their team during these heightened stress states. The behavioral health clinician on the health care team served as an advocate, enhanced trust, and allowed for increased continuity and access to care. Conclusions: Given the role of adverse childhood experiences in health outcomes and the results of this study, incorporating a trauma-informed approach is essential to treating patients with adverse childhood experiences. We propose that integrating mental health professionals into primary care settings better serves patients with trauma histories. [ABSTRACT FROM AUTHOR]

This study aimed to prospectively identify ecological risk factors for juvenile arrest in a sample of youth at risk for maltreatment. Chi-Squared Automatic Interaction Detector analysis was performed with data from 592 youth from the Longitudinal Studies of Child Abuse and Neglect to identify the optimal combination of age 14 predictors of past-year arrest at age 16. Results extended previous research, which has identified being male, having more conduct disorder symptoms, suspension from school, perceived school importance, witnessing family violence, and having a jailed family member as key risk and protective factors for arrest by identifying important interactions among these risk factors. These interactions differentiate youth at the greatest risk of arrest, which, in this sample, were males with greater than two symptoms of conduct disorder who witnessed family violence. These findings suggest that longitudinal and multi-informant data could inform the refinement of actuarial risk assessments for juvenile arrest. [ABSTRACT FROM AUTHOR]

Adverse childhood experiences (ACEs) are 10 categories of childhood abuse and maltreatment, which have a dose–response relationship with common adult health concerns seen in primary care including health risk behaviors, chronic disease, and mental illness. Many of the ACEs-associated biopsychosocial risk factors are modifiable. However, physicians may not address these issues for fear of opening “Pandora’s Box”, that is, a source of extensive problems for which they are not sufficiently prepared with training, resources, or time. Residents need training in how to conduct trauma-focused conversations within the limited scope of an office visit. To address this need, a 4-hour simulation and video-based training program was developed for primary care residents about how to conduct brief interventions connecting their patients’ current health concerns with their experiences of ACEs. Resident participants have evaluated this program as preparatory for real-life encounters and as being designed to allow for educational mastery. This article describes a workshop presenting this training program which was given at the 37th Annual Behavioral Science Forum in Family Medicine. Five skills targeted in the program were presented and a demonstration was made of the components, that is, didactics, provider and patient videos, simulated patient encounters, trainee feedback, and facilitated discussion that encompasses targeted skills, clinical implementation, and self-care. Companion tools were shared, including the syllabus, evaluation rubric, and provider and patient resources. Participants practiced trainee feedback and discussed the challenges in implementation. [ABSTRACT FROM AUTHOR]