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Multiracial people report higher mean Adverse Childhood Experience (ACE) scores and prevalence of anxiety than other racial groups. Studies using statistical interactions to test if associations between ACEs and anxiety are greater for this group than others have shown mixed results. Using data from waves 1 (1995-1997) through 4 (2008-2009) of the National Longitudinal Study of Adolescent to Adult Health (Add Health), we simulated a stochastic intervention over 1000 resampled datasets to estimate the race-specific cases averted per 1000 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 1000; 95% CI; −7.42 to −1.86). The model also predicted smaller risk reductions for Black participants (−0.76; 95% CI, −1.53 to −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. This article is part of a Special Collection on Mental Health. [ABSTRACT FROM AUTHOR]

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; I2 = 0%; P <.00001), increased risk of ACEs by 1.56 (95% CI, 1.02 to 2.39; I2 = 0%; P <.04), decreased HbA1c by −0.41% (95% CI, −0.44 to −0.39; I2 = 85%; P <.00001), and decreased FBG by −13.51 mg/dL (95% CI, −14.43 to −12.59; I2 = 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; I2 = 53%; P =.25) versus a 5 mg dose and by 1.04 mg/dL (95% CI, −1.17 to 3.26; I2 = 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; I2 = 0%; P =.0008), increased the risk of ACEs by 1.26 (95% CI, 0.56 to 2.87; I2 = 0%; P =.58), decreased HbA1c by −0.4% (95% CI, −0.45 to −0.35; I2 = 89%; P <.00001), and decreased FBG by −8.39 mg/dL (95% CI, −10 to −6.77; I2 = 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. [ABSTRACT FROM AUTHOR]

Adverse Childhood Experiences (ACEs) are associated with poorer physical and mental health outcomes, which have been shown to negatively impact resilience. The prevalence of mental health diagnoses among college students is increasing in frequency and severity. Further, research shows that college students often have unmet mental health needs and underutilize professional help for mental health disorders. The purpose of this study was to better understand the relationship between ACES, resilience, mental health diagnosis, mental health treatment, and attitudes toward help-seeking. Specifically, we wanted to understand what contributes to college students seeking professional help. Nine hundred and forty-one college students from a large Southwest university completed a series of measures via a Qualtrics link. There was a significant relationship between ACE scores and previous/current mental health diagnosis (p =.001) and between ACE scores and previous/current psychological treatment (p =.001). When considering all factors together, a four-way ANOVA indicated the overall model was significant, but only current/recent mental health treatment had a significant effect on attitude toward seeking professional help (p=.001). ACEs, resiliency, and mental health diagnosis did not impact attitudes toward seeking help. This study adds to the growing body of literature on understanding what contributes to college students seeking help. [ABSTRACT FROM AUTHOR]

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. [ABSTRACT FROM AUTHOR]

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. [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]

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. [ABSTRACT FROM AUTHOR]

Historically, sexual and gender minority populations may have faced multiple Adverse Childhood Experiences (ACEs) and their utilization of preventive healthcare is low. However, sociocultural changes in attitudes and policies affecting sexual and gender minority populations signal their broader societal acceptance. We examined the prevalence of ACEs among sexual and gender minority populations belonging to Generation Z (those born between 1990-early 2000s) and their utilization of preventive healthcare to identify areas for health promotion. We used the Philadelphia Expanded ACEs questionnaire as well as questions about demographics and preventive healthcare use in a cross-sectional online survey design. The participants (n = 160) were chiefly female (n = 105, 65.6%) and bisexual (n = 51, 31.9%), while gender non-binary comprised 10.6% (n = 17). Most (93.75%, n = 150) participants reported three or more ACEs. ACEs were significantly associated with preventive healthcare use (p = 0.02). Higher prevalence of ACEs was associated with a 0.05 reduction in preventive healthcare utilization. Despite protective factors such as a comparatively advantaged background (based on their annual household income), health insurance, and college education, high ACEs, sexual orientation, and gender identity remained significantly associated with low utilization of preventive healthcare. [ABSTRACT FROM AUTHOR]

Adverse Childhood Experiences (ACEs) affect almost half of youth in the U.S. and are linked to a host of deleterious medical and psychosocial outcomes. The current study examines the relationships among ACEs, childhood obesity, and modifiable lifestyle behaviors to inform clinical care, future research, and policy. Using data from the 2016–2018 National Survey of Children's Health (NSCH), associations between children's ACEs, weight status, and health behaviors that may influence the link between ACEs and obesity were examined. In the NSCH data, 25.3% of youth aged 10–17 years experienced one ACE with another 25.9% experiencing two or more ACEs. Having ACEs was related to excess screen time and inadequate sleep, and independently associated with obesity. Findings highlight the importance of providers screening and finding ways to intervene on behalf of youth with obesity. The present provides guidelines for providers on intervening with youth experiencing ACEs. [ABSTRACT FROM AUTHOR]

Intimate partner violence (IPV), which can include physical and psychological harm toward an intimate partner, is a significant problem on college campuses with 20%–50% of college students reporting victimization during their college careers. The intergenerational transmission of violence theory suggests that Family of Origin Violence (FOV; e.g., witnessing IPV between parental figures and experiencing childhood physical abuse) increases the likelihood of perpetrating IPV as an adult. FOV is also associated with an increased risk of developing antisocial personality traits, a correlate of IPV perpetration. We examined whether antisocial personality traits explained the relationship between FOV (i.e., experiencing and witnessing) and four different types of emotional partner abuse (i.e., restrictive engulfment, denigration, hostile withdrawal, and dominance/intimidation) while controlling for sex, alcohol, and drug use/problems. Experiencing FOV positively associated with restrictive engulfment emotional partner abuse (B =.04, 95% CI [.01,.08]), hostile withdrawal emotional partner abuse (B =.07, 95% CI [.03,.13]), and dominance/intimidation emotional partner abuse (B =.04, 95% CI [.01,.09]) through antisocial personality traits. These findings have implications for the long-term consequences of FOV. [ABSTRACT FROM AUTHOR]

Rheumatoid arthritis (RA) is a chronic inflammatory disease, causing joint-swelling and pain. International literature highlights that patients with RA are more likely to report high levels of alexithymia, adverse childhood events (ACEs) and stress, but studies investigating the association between these dimensions are lacking. The general aim of the present study is to investigate the association between alexithymia, ACEs, and stress in RA patients and to highlight possible predictors of greater perceived stress. One hundred and thirty-seven female patients with RA (mean age = 50.74; SD = 10.01) participated in an online survey between April and May 2021. Participants completed a questionnaire for the collection of sociodemographic and clinical information, the 20-item Toronto Alexithymia Scale, the Adverse Childhood Events questionnaire and the 10-item Perceived Stress Scale. The correlational analysis highlighted several significant associations between the dimensions evaluated. Regression analyses showed that alexithymia, ACEs and the perceived health status have a predictive effect on the perceived stress of RA patients. More specifically, the role of difficulty in identifying feelings, and the physical and emotional neglect, has been highlighted. ACEs and high levels of alexithymia are common in RA clinical populations and seem to affect the wellbeing of these patients. The use of a biopsychosocial approach to RA treatment appears essential in achieving a better quality of life and illness control in this specific clinical population. [ABSTRACT FROM AUTHOR]

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

Background: Homelessness is a major public health problem among U.S. military veterans. However, contemporary, population-based data on the prevalence, correlates, and mental health burden of homelessness among veterans are lacking. Methods: Data were analyzed from the 2019–2020 National Health and Resilience in Veterans Study, a nationally representative survey of veterans (n = 4069). Analyses examined the prevalence and correlates of homelessness, as well as the independent associations between homelessness and current probable psychiatric conditions, suicidality, and functioning. Results: The lifetime prevalence of homelessness was 10.2% (95% confidence interval 9.3–11.2). More than 8-of-10 veterans reported experiencing their first episode of homelessness following military service, with a mean of 10.6 years post-discharge until onset (s.d. = 12.6). Adverse childhood experiences (ACEs), cumulative trauma burden, current household income, younger age, and drug use disorder emerged as the strongest correlates of homelessness (49% of total explained variance). Veterans with a history of homelessness had elevated odds of lifetime suicide attempt, attempting suicide two or more times, and past-year suicide ideation [odd ratios (ORs) 1.3–3.1]. They also had higher rates of current probable posttraumatic stress disorder, major depressive, generalized anxiety, and drug use disorders (ORs 1.7–2.4); and scored lower on measures of mental, physical, cognitive, psychosocial functioning (d = 0.11–0.15). Conclusions: One in ten U.S. veterans has experienced homelessness, and these veterans represent a subpopulation at substantially heightened risk for poor mental health and suicide. ACEs were the strongest factor associated with homelessness, thus underscoring the importance of targeting early childhood adversities and their mental health consequences in prevention efforts for homelessness in this population. [ABSTRACT FROM AUTHOR]

Adverse childhood experiences (ACEs) are consistently found to be negatively associated with physical, psychological, and psychosocial well-being throughout the lifespan. While previous research has established risk factors and noxious outcomes arising post-ACEs, less attention has been given to factors such as resilience, perceived social support, and subjective well-being that may help explain the relationship between ACEs and psychopathology. Hence, the objectives of this study are to examine: (1) the relationships among ACEs and symptoms of anxiety, depression, and suicidality in adulthood, and (2) whether resilience, social support, and subjective well-being mediate the relationship between ACEs and psychopathological symptoms. Cross-sectional data on ACEs, psychological factors, potential mediating variables, and sociodemographic factors were collected from a community sample of adults aged 18–81 (N = 296) via an on-line survey. Endorsing ACEs was significantly and positively correlated with symptoms of anxiety, depression, and suicidality. Results of parallel mediation analyses showed that social support, negative affect, and life satisfaction statistically mediated the relationships between ACEs and psychopathological outcomes in adulthood. These results highlight the importance of identifying potential mediators of the ACEs-psychopathological symptoms relationship to aid in the development of screening and intervention practices that could bolster developmental outcomes following traumatic childhood experiences. [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]

Depression and anxiety are common and persistent internalizing disorders during adolescence. The present study aimed to explore whether family resilience would moderate the effects of bullying victimization, Adverse Childhood Experiences (ACEs), and poverty status on adolescent internalizing disorders. This study used the 2016 National Survey of Children's Health (NSCH) and included 20,708 adolescents aged 12 to 17 years (M = 14.7, SD = 1.70). Hierarchical multiple regression was conducted to examine the relationship of bullying victimization, ACEs, and poverty status with adolescents' internalizing disorders and explore the moderating role of family resilience on that relationship. The study found positive associations of bullying victimization, ACEs, and poverty status with adolescents' internalizing disorders. Family resilience moderated the effects of bullying victimization and ACEs on adolescents' internalizing disorders. The findings suggest that to prevent adolescents' internalizing disorders, it is critical to promote family resilience and reduce bullying victimization, ACEs, and poverty. [ABSTRACT FROM AUTHOR]

Previous studies have examined the associations between adverse childhood experiences (ACEs), a measure of childhood trauma, and multiple mental health outcomes in adult life. ACEs have been linked to adult health risks such as violence, aggression, sexual behavior, and problem substance use. Substance use may be a strategy for coping with the psychological effects of early trauma. Archival data from inpatient and outpatient treatment programs included the following information for approximately 2,300 participants: gender, ACEs, the primary substance used, and the number of previous treatment episodes. The data set included 970 females (42.2%) and 1,326 males (57.8%). Females obtained significantly higher ACEs scores than males. In addition, the females in the current sample exhibited significantly higher ACEs scores than females in a general, non-clinical population. Other findings indicated a small significant positive correlation between ACEs score and the number of treatment episodes. ACEs scores also differed by participants reported primary substance of choice with significantly higher ACEs scores for methamphetamine/ other opiates/synthetics and other amphetamines. [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]

Objectives Age stereotypes and expectations about one's own aging commence in childhood, while most research focuses on predictive associations with midlife cognition and health outcomes in later life. This study instead aims to examine adverse childhood experiences (ACEs) contributing to multiple measures of subjective age (SA) among Chinese older adults and test whether these relationships differ by household registration (hukou). Methods In a representative sample of Chinese older adults aged 60 and older from the 2018 China Longitudinal Aging and Social Survey (n = 7,815), ordinary least squares is used to examine the associations between ACEs and 3 facets of SA: felt age, look age, and self-defined aging standard. Results Childhood starvation experience and limited health care access predict older felt age and look age, while parental death is associated with lower self-defined aging standard. Zooming in on hukou -specific associations shows that the dose–response relationship on older adults with rural hukou is particularly pronounced. Discussion Findings provide empirical support for views of aging from a life-course perspective and highlight the enduring impact of ACEs for late-adulthood SA, as well as their differential influence on multiple indicators of SA. Interventions that focus on promoting health and development in childhood could potentially have effects beyond the childhood phase, and benefit for their positive aging attitude in later life. [ABSTRACT FROM AUTHOR]

Young adults with adverse childhood experiences (ACEs) face greater risks for health complications, homelessness, and court involvement. However, research on trauma interventions for young adults is minimal. Thus, this study examines the experiences of young adults participating in a six-week trauma psychoeducation group to explore aspects of group experience that could potentially increase the benefits and efficacy of such intervention. The group combined trauma psychoeducational content on ACEs and resilience, practice of coping skills during sessions, and traditional group processing techniques. Participants were asked to respond to open-ended questions on the most helpful aspects of the group and any insights gleaned. Qualitative results suggest that the therapeutic group context is vital in effectively presenting psychoeducational content. These findings indicate that this group model, which integrates psychoeducation and traditional group techniques, has the potential to help young adults develop the resilience needed to reverse the negative impacts of ACEs and prevent future adversity. [ABSTRACT FROM AUTHOR]

Background: Children of mothers with adverse childhood experiences (ACEs) are at increased risk for developmental problems. However, the mechanisms through which a mother's experience of ACEs are transmitted to her offspring are understudied. The current study investigates potential modifiable mediators (maternal psychopathology and parenting) of the association between maternal ACEs and children's behavioral problems. Methods: We utilized data from a pregnancy cohort study (N = 1030; CANDLE study) to investigate longitudinal associations between maternal ACEs, postpartum anxiety, observed parenting behavior, and child internalizing behaviors (mean age = 4.31 years, s.d. age = 0.38) in a racially diverse (67% Black; 33% White/Other) sample. We used structural equation modeling to test for direct associations between maternal ACEs and children's internalizing behaviors, as well as indirect associations via two simple mediations (maternal anxiety and parenting), and one serial mediation (sequence of maternal anxiety to parenting). Results: Simple mediation results indicated that maternal anxiety and cognitive growth fostering behaviors independently mediated the association between maternal ACEs and child internalizing. We observed no evidence of a serial mediation from ACEs to internalizing via the effects of maternal anxiety on parenting. Conclusions: This study supports and refines extant literature by confirming the intergenerational association between maternal ACEs and child internalizing behaviors in a large, diverse sample, and identifies potential modifiable mediators: maternal anxiety and parenting behaviors related to fostering cognitive development. Findings may inform interventions targeting mothers who have experienced ACEs and suggest that providing support around specific parenting behaviors and addressing maternal anxiety may reduce internalizing behaviors in children. [ABSTRACT FROM AUTHOR]

Background: The occurrence of early childhood adversity is strongly linked to later self-harm, but there is poor understanding of how this distal risk factor might influence later behaviours. One possible mechanism is through an earlier onset of puberty in children exposed to adversity, since early puberty is associated with an increased risk of adolescent self-harm. We investigated whether early pubertal timing mediates the association between childhood adversity and later self-harm. Methods: Participants were 6698 young people from a UK population-based birth cohort (ALSPAC). We measured exposure to nine types of adversity from 0 to 9 years old, and self-harm when participants were aged 16 and 21 years. Pubertal timing measures were age at peak height velocity (aPHV – males and females) and age at menarche (AAM). We used generalised structural equation modelling for analyses. Results: For every additional type of adversity; participants had an average 12–14% increased risk of self-harm by 16. Relative risk (RR) estimates were stronger for direct effects when outcomes were self-harm with suicidal intent. There was no evidence that earlier pubertal timing mediated the association between adversity and self-harm [indirect effect RR 1.00, 95% confidence interval (CI) 1.00–1.00 for aPHV and RR 1.00, 95% CI 1.00–1.01 for AAM]. Conclusions: A cumulative measure of exposure to multiple types of adversity does not confer an increased risk of self-harm via early pubertal timing, however both childhood adversity and early puberty are risk factors for later self-harm. Research identifying mechanisms underlying the link between childhood adversity and later self-harm is needed to inform interventions. [ABSTRACT FROM AUTHOR]

Most adults in the United States report experiencing at least one adverse childhood experience (ACE), with around a quarter of the population reporting three or more. ACEs impact adult biological (e.g., hypothalamic-pituitary-adrenal axis) and psychosocial (e.g., loneliness) functioning, including cognitive patterns in stressful situations. As one example, pain catastrophizing is an emotional and cognitive reaction to pain that is closely related to low distress tolerance. We hypothesized that women with more ACEs would report greater levels of pain catastrophizing in adulthood, an effect potentially mediated via higher levels of loneliness (i.e., perceived lack of social support). Biologically female participants (N=109; 39.8±14.0 years of age; 83.5% white) were recruited through Mechanical Turk and a university online recruitment tool, and completed an online survey including demographics, the 10-item Adverse Childhood Events Scale, the 13-item Pain Catastrophizing Scale, and the 20-item UCLA Loneliness Scale Version 3. A bootstrapped mediation analysis examined the relationships between ACEs and pain catastrophizing via loneliness. Results indicated that loneliness had a significant indirect effect on the relationship between ACEs and pain catastrophizing (indirect effect=0.69; 99% CI=0.15–1.40) such that increased ACEs were related to greater loneliness, which, in turn, was related to greater pain catastrophizing. The present study adds to the literature by suggesting that loneliness is a possible mechanism by which ACEs adversely impact cognitive and emotional well-being in adulthood. Per social cognitive theory, loneliness influences social cognitions, which might make dealing with stressful situations such as pain more difficult and, therefore, increase one's catastrophic thinking patterns. [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: Connecting patients to treatment for a substance use disorder (SUD) that satisfies their needs is often complicated by confounding factors. A reliable measurement of patients' underlying stress level may be helpful because it often reflects many of the same confounders as their SUD. Whereas cortisol levels reflect physiological responses to stress, patients' cortisol levels during recovery from an SUD may serve as biomarkers for stressors that result in poor treatment outcomes, including early discontinuation of treatment. However, further exploration of the relationship between patients' cortisol levels and their treatment outcomes is needed for this approach to be clinically useful. Methods: We enrolled participants from an abstinence‐based, male‐only, residential alcohol and drug recovery program to examine the relationship between salivary cortisol, stress exposure, ACEs, and treatment retention. Results: Participants who remained in the program <90 days had significantly higher initial cortisol levels than those who remained ≥90 days (0.62 ± 0.074 μg/dl vs. 0.36 ± 0.037 μg/dl). Kaplan–Meier curves differed significantly when we grouped participants according to whether their cortisol level was below or above the overall average of 0.49 ± 0.044 μg/dl, with the median numbers of days before discontinuing being 110 and 60, respectively. A Cox proportional hazards model indicated that elevated salivary cortisol (with increases in μg/dl), marital/relationship status, and adverse childhood experiences (ACEs) score correlated significantly with hazards of discontinuing the program (hazard ratios for the three factors were 3.49, 2.39, and 1.50, respectively). Discussion: Cortisol level may predict, at least partially, SUD treatment program retention regardless of individuals' numerous confounding factors or the substance used. If this approach is validated, it could enable providers to consider patients' cortisol levels at the time of admission to treatment to facilitate their retention in treatment and thereby enhance their recovery. [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]

Background: Although adverse childhood experiences (ACEs) in adolescents are partially presented at the national level, few studies of ACEs in working adolescents by comparing them with those who are not working that provide an opportunity for international comparison have been conducted. Objective: This study was aimed to compare the ACEs of working and nonworking adolescents. Methods: This study was conducted in Turkey with 213 working adolescents enrolled in the vocational training center and 457 nonworking adolescents enrolled in high schools between the ages of 15 and 18. Results: As a result of the study, the prevalence and incidence of psychological and physical ACEs and neglect in nonworking adolescents were found to be higher than the prevalence and incidence in working adolescents. Conclusions: Research should be conducted to define the awareness of neglect and abuse among working and nonworking adolescents and to explain the reasons why nonworking adolescents experience more ACEs. [ABSTRACT FROM AUTHOR]

Previous studies confirm that attachment representations are very stable and are rooted in semantic and episodic autobiographic memory systems. The Adult Attachment Interview (AAI) provides a means to assess secure, insecure, and disorganized (U) states of mind; it incorporates a fine-grained analysis of attachment-related memories. The AAI is not a measure to determine false versus true memories or to claim it can identify veridical truth; however, longitudinal research studies demonstrate that the AAI is highly stable in how (degree of coherence) the speaker discusses past events. This IRB approved study (n = 130) examined a non-clinical sample of active individuals. The results indicated that passive states of mind was a predictor variable for unresolved loss and unresolved childhood abuse and both passive states of mind and more Adverse Childhood Experiences (ACEs) predicted overall lack of resolution (U). Lack of memory and dissociative amnesia were not significant predictors. This study and previous studies demonstrate that retrospective reporting of ACEs remain stable over time. These findings suggest that clinical focus should follow the attachment protocol of examining the state of mind of the speaker. Autobiographical memory systems reveal enduring Internal Working Models (IWMs) that influence how memories are stored and recounted. [ABSTRACT FROM AUTHOR]

Early developmental success and school readiness strongly influence future skill development, occupational opportunities, and health. Therefore, it is critical to identify and address early determinants of school readiness for supporting children's overall well-being and success. In this retrospective cohort study, we examined the effects of pre-birth household challenges, such as homelessness or experiences of intimate partner violence, on children's early school readiness. We linked data from the Alaska 2009–2011 Pregnancy Risk Assessment Monitoring System (PRAMS) to administrative and education records through 2019. Education records included kindergarten developmental scores, third grade reading assessments, and attendance records. Generalized linear models with Quasi-Poisson distributions for each outcome of interest examined the predictive value of pre-birth household challenges on the risks of not meeting school readiness expectations. We found that experiencing higher numbers of pre-birth household challenges was related to higher risk of the child not meeting developmental and reading proficiency and having chronic absenteeism. These results suggest that it is imperative support systems for pregnant persons and their families be introduced as soon as possible in pre-natal care routines to address current pre-birth household stressors and prevent future challenges. Such early prevention efforts are needed to ensure the best possible developmental start for children. [ABSTRACT FROM AUTHOR]

Purpose: This study aimed to explore how forensic mental health service users make sense of their past adverse experiences. Secondly, it aimed to explore whether service users considered their adverse experiences to be related to their current stay in a forensic mental health setting. Design/methodology/approach: Interpretative phenomenological analysis was used to analyse interviews with eight service users in low and medium secure care. Six of the participants were male and two were female. Findings: Four super-ordinate themes emerged from the data: "Living amongst adversity"; "Managing adverse experiences"; "Making sense of going into secure care"; and "Coping with the past in the present". All participants referred to multiple adverse experiences throughout their lives and used harmful coping strategies to manage these. Individual differences in how they related their past experiences to their detention in secure care were evident. Practical implications: Author guidelines state that this section is optional. Implications for clinical practice are discussed at length in the discussion section. Originality/value: This study offers an insight into the way in which forensic mental health service users make sense of their past traumas in relation to their current admission to secure services. To the best of the authors' knowledge, no research has previously addressed this from the perspective of service users. [ABSTRACT FROM AUTHOR]

Several vulnerability factors for suicidal behavior in U.S. veterans have been identified. However, little is known about factors that differentiate veterans who contemplate suicide from those who attempt suicide. This study examined sociodemographic and clinical characteristics that distinguish veterans who think about suicide from those who attempt suicide. Data were analyzed from the 2019–2020 National Health and Resilience in Veterans Study, which surveyed a population-based sample of 4069 veterans. Analyses estimated the lifetime prevalence of suicide ideation (SI) and suicide attempts (SA); and examined differences between veterans with a history of attempt(s), and SI without a history of attempt(s). A total 25.9% of U.S. veterans reported lifetime SI and 3.9% reported a SA. Several factors distinguished veterans with a history of SA from those with SI only: the strongest were younger age (odds ratio [OR] = 0.97, 95% CI = 0.95–0.98), nonsuicidal self-injury (OR = 1.81, 95% CI = 1.11–3.03), adverse childhood experiences (OR = 1.14; 95% CI = 1.06–1.23), alcohol use disorder (OR = 1.99; 95% CI = 1.28–3.12), lower household income (OR = 0.62; 95% CI = 0.40–0.95), and physical disability (OR = 1.69; 95% CI = 1.07–2.70). Although a quarter of U.S. veterans contemplate suicide in their lifetimes, the majority do not attempt suicide. Specific sociodemographic and clinical features may differentiate veterans who contemplate versus attempt suicide. [ABSTRACT FROM AUTHOR]

The pediatric primary care setting offers a promising platform for delivering positive parenting interventions as a strategy to prevent childhood adversity and behavioral health issues. This pilot project assessed parents' acceptability and perspectives of Parent ConnextTM, a positive parenting and prevention program that includes screening for parenting and family psychosocial concerns by pediatricians and individualized parent coaching for parents by co-located Parenting Specialists. Eleven pediatric practices implemented Parent ConnextTM over a three year period, and 1,301 families participated in parent coaching. Parents were invited to complete surveys on parenting and psychosocial factors at sessions 1, 3, and 3 months follow-up and were emailed a satisfaction survey after their last session and invited to participate in a phone interview. A subsample of 280 biological mothers who completed surveys at multiple time points showed improved parenting satisfaction, parenting efficacy, and parent-child interaction and reduced psychosocial concerns over time. The majority (≥97%) of the 387 parents who completed the satisfaction survey reported satisfaction with the accessibility, convenience, and quality of the parent coaching service. Nearly all 27 parents interviewed (96%) reported being highly likely to recommend the service to a friend or parent, and most (84%) felt their needs had been met. Parents described the key program attributes to include normalization of their experiences, non-judgmental support, easy-to-implement tailored strategies, and empowerment in parenting. Overall, parents found Parent ConnextTM to be a worthwhile addition to their pediatric primary care. Alternative payment models are needed to support the sustainability of integrated programs like Parent ConnextTM. Highlights: Parenting Specialists provided parent coaching to parents at 11 pediatric practices. Parenting efficacy, parenting satisfaction, and parent-child interaction improved in participating mothers. 97% of parents were satisfied with the quality and accessibility of parent coaching. Parents most appreciated the normalizing, non-judgmental support and empowerment. Parents found the concrete, tailored parenting strategies received to be beneficial. [ABSTRACT FROM AUTHOR]

Descriptive adverse childhood experience (ACE) prevalence data on parenting women seeking treatment for opioid use disorder (OUD) is limited, despite this group being one of the fastest growing sub-populations of the opioid epidemic. The aim of this study was to: (1) determine prevalence of ACEs) in a population of parenting women in treatment for OUD, (2) characterize ACEs, and (3) compare study ACE data to Pennsylvania Behavioral Risk Factor Surveillance System (PA BRFSS) to normalize study results. Between 2014 and 2018, ACEs were collected from parenting women (N = 152) enrolled in treatment for OUDs. Results showed on average women were 30.3 years of age (SD 4.6, range 22–41 years) non-Hispanic (87.0%), white (74.0%), and held a high school education or less (76.0%). The mean total ACE score was 4.3 (SD 2.3; range 0–8). Most women reported 4 ≥ ACEs (65.0%), while only 5.0% reported 0 ACEs. The current sample had higher mean ACE score (4.3 PSMDT vs. 1.4 PA BRFSS Data) than PA BRFSS Data. The burden of ACEs in parenting women in treatment for OUD is significant. Understanding the trauma parenting women in drug treatment have experienced, may support efforts to reduce stigma of this population. Public health intervention and policy work that is trauma proactive is needed to address this growing epidemic. [ABSTRACT FROM AUTHOR]

Research shows that exposure to adverse childhood experiences (ACEs) is common among adolescents and that exposure to ACEs is associated with an increased risk of depression in adolescents. Furthermore, it is unknown whether resilience and spirituality moderate the association between ACEs and depression in African-American adolescents. Thus, the present study examined the prevalence of ACEs and the association between ACEs and the risk for depression in African-American adolescents and examined whether this association is moderated by resilience and spirituality. Survey data were collected from African-American adolescents who attended youth-targeted events held by churches in Houston, TX. An expanded ACE tool was used to collect data and respondents were dichotomized into two groups based on their summed ACE scores, i.e., 0–3 ACEs versus 4–19 ACEs. Logistic regression was conducted to examine the association between ACEs and the likelihood of depression and to examine whether this association is moderated by resilience and spirituality. The results indicate that half of the sample had been exposed to four or more ACEs and that ACEs are negatively associated with depression: higher levels of resilience and spirituality suggest a lower likelihood of depression. These results suggest the need to explore the prevalence of cumulative ACEs among homogenous samples of African-American adolescents and the need to continue exploring and addressing the prevalence of individual ACEs among homogenous samples of African-American adolescents. No clinical trials were performed for this study. [ABSTRACT FROM AUTHOR]

Purpose: To examine whether adverse childhood experiences (ACEs) are associated with breastfeeding behaviors. Methods: Women in three Kaiser Permanente Northern California medical centers were screened for ACEs during standard prenatal care (N = 926). Multivariable binary and multinomial logistic regression was used to test whether ACEs (count and type) were associated with early breastfeeding at the 2-week newborn pediatric visit and continued breastfeeding at the 2-month pediatric visit, adjusting for covariates. Results: Overall, 58.2% of women reported 0 ACEs, 19.2% reported 1 ACE, and 22.6% reported 2+ ACEs. Two weeks postpartum, 92.2% reported any breastfeeding (62.9% exclusive, 29.4% mixed breastfeeding/formula). Compared with women with 0 ACEs, those with 2+ ACEs had increased odds of any breastfeeding (odds ratio [OR] = 2.7, 95% confidence interval [CI] = 1.3–5.6) and exclusive breastfeeding 2 weeks postpartum (OR = 3.0, 95% CI = 1.4–6.3). Among those who breastfed 2 weeks postpartum, 86.4% reported continued breastfeeding (57.5% exclusive, 28.9% mixed breastfeeding/formula) 2 months postpartum. ACE count was not associated with continued breastfeeding 2 months postpartum. Individual ACEs were not related to breastfeeding outcomes, with the exception that living with someone who went to jail or prison was associated with lower odds of continued breastfeeding 2 months postpartum. Conclusions: ACE count was associated with greater early breastfeeding, but not continued breastfeeding, among women screened for ACEs as part of standard prenatal care. Results reiterate the need to educate and assist all women to meet their breastfeeding goals, regardless of ACE score. [ABSTRACT FROM AUTHOR]

Objectives: Adverse childhood experiences (ACEs) are associated with lasting health and behavioral effects. In this study, we assess the relationship between ACEs and gambling in the state of Nevada. Methods: Using 2018 Nevada Behavioral Risk Factor Surveillance System (BRFSS) data, we assessed the relationship between ACEs and gambling behavior among 2768 participants. A composite score was used to assess 10 commonly researched ACEs; this continuous score was additionally categorized into 0 ACEs, 1-2 ACEs, 3 or more ACEs. We used weighted logistic regression to assess the relationship between ACEs scores and frequency of gambling. Results: Approximately 9% of study participants reported frequently gambling (one or more times a month). There was a positive association between the continuous ACEs score and frequently gambling in the fully adjusted model (p = .026). The odds of frequently gambling was 69% higher among those exposed to ≥ 3 ACEs compared to those who had no ACEs exposure (adjusted OR = 1.69; 95% CI 1.00-2.84; p = .048). Conclusions: The results show a relationship between ACEs and gambling in Nevada. This research contributes to the existing understanding of ACEs and their impact. [ABSTRACT FROM AUTHOR]

There is limited research on the short-term effects of ACEs on Black children and youth. Black children and youth are disproportionately exposed to abuse, neglect, and other victimizations (Drake et al. 2009; Wade et al. Journal of Family Issues, 17(3), 283–316, 2014). Investigating ACEs will provide a broader understanding of childhood trauma on developmental processes. The current study investigates how ACES impacts psychological distress, substance use, and delinquency among Black children and youth. Hypotheses were tested using a subsample of longitudinal data from 265 participants who were recruited from six school districts in Southeast Michigan. ACEs at T1 significantly predicted depressive symptoms at T2 (β =.19, p <.05), which in turn predicted substance use (β =.20, p <.05), and delinquency (β =.19, p <.05). Psychological distress also mediated the associations between ACEs and substance use, and delinquency. To engage youth in prevention/interventions and practice, it is important to understand the contexts in which they develop i.e. having knowledge on the specific type of victimization instances that Black youth may experience more than their peers as well as the social factors. Therefore, taking a trauma-informed approach that will acknowledge the adverse childhood experiences that youth went through and to understand how these experiences shape their development through adolescence may be efficacious. [ABSTRACT FROM AUTHOR]

Objectives: To determine the adverse childhood experience scores (ACES) of nursing students in the United States. Methods: Utilized the standardized Family Health History Questionnaire to determine the ACES of a national sample of nursing students. Simple descriptive statistics were used to analyze the findings. Results: Nursing students ACES indicate that they enter academia with a much higher baseline of childhood trauma versus the general population. Over 40% of nursing students surveyed had an ACES of 4 or more versus the national average of 12.5–13.3% of the general population having an ACES of 4 or more. Conclusions: This data provides support for Conti-O'Hare's theory of nurses as wounded healer. Nursing faculty should consider nursing students to be members of a vulnerable population and revise curricula to support nursing students stress resilience. [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]

Background: Research suggests that there is a dose–response relationship between Adverse Childhood Experiences (ACEs) and cigarette smoking, such that as ACE score increases, so do the odds of smoking behavior, but little is known about what factors moderate this relationship. Objectives: The goal of this study was to examine demographic characteristics as potential moderators of relationship between ACE score and cigarette smoking. Methods: A secondary data analysis was conducted using the 2013 California Behavioral Risk Factor Surveillance System data. The sample included 2,604 U.S. adults (54.8% female; Age: M = 53.3, SD = 8.10). We used multinomial logistic regression to test sex, race, income, and education as moderators of the relationship between ACE score and smoking. Results: ACEs were not significantly associated with smoking behavior. No interactions between ACE score and sex, race, education, or income significantly predicted smoking outcomes. Sex, race, education, and income were significantly and independently associated with smoking outcomes. Men, individuals with lower income and education, and certain ethnic/racial groups reported greater odds of smoking. Conclusions/Importance: Results suggest that there may not be a relationship between ACEs and smoking later in life. Additionally, the relationship between ACEs and smoking in adulthood may not depend on basic demographic features. Knowing which populations are more vulnerable to smoking can help clinicians better assess and tailor interventions to meet the needs of their patients by using culturally sensitive interventions and obtaining resources to help improve treatment access, motivation, and success. [ABSTRACT FROM AUTHOR]

Objectives Research on adverse childhood experiences (ACEs) has provided a valuable framework for understanding associations between childhood maltreatment and family dysfunction and later poor health outcomes. However, increasing research suggests the number and types of childhood adversities measured warrants further examination. This study examines ACE exposure among adults who experienced homelessness in childhood, another type of childhood adversity. Methods This cross-sectional, descriptive study used the 2016 South Carolina (SC) Behavioral Risk Factor Surveillance System (BRFSS) survey and additional ACE modules to examine ACE exposure among SC adults and childhood homelessness. Standard descriptive statistics were calculated for each variable. Bivariate analysis compared types and number of ACEs by childhood homeless status. All analyses used survey sampling weights that accounted for the BRFSS sampling strategy. Results Data from 7490 respondents were weighted for analyses. Among the 215 respondents who reported homelessness in childhood, 68.1% reported experiencing four or more ACEs. In contrast, only 16.3% of respondents who reported no homelessness in childhood reported experiencing four or more ACEs. The percent of respondents was significantly higher for each of 11 ACEs among those who reported childhood homelessness, compared to those who did not. Conclusions for Practice Adults who reported homelessness in childhood also reported significantly greater exposure to higher numbers and types of ACEs than adults reporting no childhood homelessness. Study findings can be important in informing additional indicators important to the assessment of ACEs and to program developers or organizations that provide housing assistance to at-risk families and children. [ABSTRACT FROM AUTHOR]

The purpose of this study was to gather population-specific data within a pediatric hospital and contribute to understanding the intergenerational continuity of adverse childhood experiences (ACEs). This descriptive study aimed at measuring the ACE scores of parents or caretakers whose child was a suspected victim of abuse or neglect. The "Finding Your ACE Score questionnaire was used to determine participants' scores." Fifteen participants enrolled in the study (N = 15), and 86.7% had exposure to ACEs. Statistical significance was found when comparing ACE scores with reported income levels (p = .051). This study supports previous findings of ACEs being present in a variety of populations, and it presents practice implications for advance practice registered nurses (APRNs) in various practice settings. Findings support that research regarding how to assess and treat ACEs throughout family members is both necessary and difficult. Additional data regarding the intergenerational continuity of ACEs might influence how APRNs deliver family-specific assessment, treatment, and prevention of ACEs throughout generations of family members. [ABSTRACT FROM AUTHOR]

• Make available a validated French version of the ACE-IQ. • The French translation of the ACE-IQ has good psychometric properties organized around three dimensions (Childhood maltreatment, Family dysfunction, Violence outside the home) • The ACE-IQ is a reliable and valid measure for assessing ACEs in French-speaking populations, both for research purposes and clinical practice. • To enable a measurement of a dose–response relationship between adverse childhood experiences (ACEs) and health decline in adulthood. Since Dr. Vincent Felitti conducted his seminal work on adverse childhood experiences (ACEs) in the 1980′s, a large body of literature has emerged concerning the relation between early life adversity and physical and psychological health outcomes in adulthood. The objective of this study was to assess the psychometric properties of the French version of the Adverse Childhood Experiences International Questionnaire (ACE-IQ). A validated translation of the ACE-IQ will facilitate comparing data in French-speaking countries where this tool is used to measure a dose–response relationship between adverse childhood experiences (ACEs) and health decline in adulthood. The ACE-IQ is a 29-item measure designed to assess exposure to ACEs categorized into three groups: maltreatment (all forms of physical and emotional ill-treatment, sexual abuse, neglect), family dysfunction and violence outside the home. The questionnaire was translated and back-translated according to guidelines and methodology defined by the World Health Organization, 2011 (WHO). A total of 367 participants were recruited to take part in this study. After analyzing descriptive statistics, we assessed the questionnaire's internal structure using principal component factor analysis. Based on classical test theory we calculated internal consistency and test–retest reliability. We then performed an item response theory (IRT) analysis using a partial credit model (PCM) for polytomous data, which was applied to each of the three dimensions of the ACE-IQ. Taken together, our results suggest that while the original three-factor structure was not fully supported, the psychometric properties were good. A high degree of overall internal consistency was demonstrated with an alpha coefficient of 0.80. For the three dimensions of the questionnaire Cronbach's alphas ranged between 0.77 and 0.41. In terms of temporal stability, we observed a good intra-class correlation of 0.79 for the entire questionnaire, with temporal stability for the three dimensions ranging between 0.78 and 0.61. Finally, our IRT analysis revealed discrepancies on certain items for each of the three dimensions, which confirm, and complete findings previously obtained through classical analysis. The French translation of the ACE-IQ has good psychometric properties which make it a reliable and valid measure for assessing ACEs in French-speaking populations, both for research purposes and clinical practice. Further validation will be necessary, however, to account for different cultural characteristics and perspectives between French speaking countries. [ABSTRACT FROM AUTHOR]

• Foster parents' adverse childhood experiences (ACEs) related to adult attachment anxiety and avoidance. • Foster parents' number of ACEs related to attachment avoidance. Emotional abuse related to attachment anxiety. • Foster parents' ACEs related to higher levels of parenting stress. Parental distress related to sexual abuse. • Foster parents' attachment anxiety related to parental distress and defensive responding. Connections between parents' trauma histories, adult attachment, and parenting stress are well established; those who have experienced trauma are more likely to have higher levels of insecure attachment (Jacobvitz & Reisz, 2019) and are more vulnerable to parenting stress (Steele et al., 2016) These processes in foster parents are understudied, even though they care for vulnerable children. This study examined relations between foster parents adverse childhood experiences (ACEs), adult attachment, and parenting stress. This is important to address because foster parents care for vulnerable children who can present unique stressors to caregivers. Examine links between ACEs, adult attachment, and parenting stress in foster parents. Participants were 55 foster parents from central Texas, US, recruited from a larger RCT study. Participants completed the ACEs questionnaire, Experiences in Close Relationships questionnaire, and Parenting Stress Inventory. Foster parents who reported higher total ACEs were more likely to report higher levels of attachment avoidance and higher levels of overall parenting stress. Foster parents who reported experiencing childhood emotional abuse reported higher levels of attachment anxiety. Those who reported experiencing childhood sexual abuse reported higher levels of parental distress. Lastly, those who reported higher levels of attachment anxiety reported higher levels of parental distress and defensive responding. ACEs are an important factor for foster parents, particularly for parenting stress. It is crucial that appropriate support is provided to help foster parents manage parenting stress and provide optimal care for their foster children. [ABSTRACT FROM AUTHOR]

Caregiver mental health is crucial to the wellbeing of children. This is most apparent when caregivers face high levels of stress or life adversity. To study this phenomenon in the current global context, this study examined the relation between stress/disruption from the COVID-19 pandemic and the mental health of female and male caregivers. Pre-pandemic childhood adversity was considered as a moderator of this association. A multi-national sample (United Kingdom, 76%; United States, 19%; Canada, 4%, and Australia, 1%) was recruited in May 2020, of whom 348 female and 143 male caregivers of 5–18 year-old children provided data on the constructs of interest. At this time, caregivers reported on their history of adverse childhood experiences (ACEs) and COVID stress/disruption. About two months later (July 2020) caregiver mental health was evaluated. We examined differences between female and male caregivers on ACEs, COVID stress/disruption, and mental health (distress, anxiety, substance use, and posttraumatic stress). Main and interactive effects of ACEs and COVID stress/disruption on each mental health outcome were examined. Female caregivers reported higher COVID stress/disruption, more ACEs, and greater distress, anxiety, and posttraumatic stress symptoms compared to male caregivers. Among female caregivers, higher COVID stress/disruption and more adverse childhood experiences (ACEs) independently predicted all mental health outcomes, consistent with a stress accumulation model. Among male caregivers, a pattern of interactions between COVID stress/disruption and ACEs suggested that the effects of COVID stress/disruption on mental health was stronger for those with higher ACEs, especially for substance use, consistent with a stress sensitization model. Higher levels of stress and mental health difficulties among female caregivers suggests a disproportionate burden due to pandemic-related disruption compared to male caregivers. Findings speak to the disparate effects of COVID-19 on the mental health of female compared to male caregivers, and the role of pre-existing vulnerabilities in shaping current adaptation. • Cross-national sample of caregiver mental health and COVID-19 stress/disruption. • Compared to male caregivers, female caregivers report more COVID stress/disruption. • Female caregivers report higher distress, anxiety, and posttraumatic stress. • For female caregivers, COVID stress and ACEs independently predict mental health. • For male caregivers, COVID stress and ACEs interact to predict mental health. [ABSTRACT FROM AUTHOR]