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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]

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

Among graduate social work students, experiences of childhood adversity and trauma, along with secondary exposure to others' trauma, can result in negative effects. Unaddressed, this may lead to secondary traumatic stress, burnout, or difficulty sustaining effective practice. Self-care strategies that adequately promote well-being and resilience may counter negative effects. This cross-sectional study explored associations between students' reported childhood adversity, trauma, recent stress, well-being, resilience, and perceived adequacy of self-care. Students from two public universities (N = 362) completed surveys that included measures for childhood adversity, potentially traumatic events, recent stress, secondary traumatic stress, burnout, compassion satisfaction, well-being, resilience, and perceived adequacy of self-care. Descriptive, bivariate, and multivariate analyses demonstrated students experienced higher rates of four or more adverse childhood experiences compared to the general population (34% vs. 13%); 70% reported four or more potentially traumatic events. Despite high levels of adversity and trauma, students reported average levels of personal well-being, high levels of resilience, average-to-high levels of compassion satisfaction, and low-to-average levels of secondary traumatic stress and burnout. Adversity and trauma were positively associated with secondary traumatic stress, and negatively associated with well-being. Final models suggest perceived adequacy of self-care may support well-being, resilience, and protect against negative effects. [ABSTRACT FROM AUTHOR]

First Nations adults continue to experience significant health disparities compared to non-First Nations adults in Canada. Ongoing difficulties associated with intergenerational trauma among First Nations peoples may be examined using the adverse childhood experiences (ACEs) model, which measures various forms of abuse, neglect, and household dysfunction. We examined prevalence rates of ACEs and physical and mental health outcomes within a predominately First Nation sample of clients seeking substance use treatment from a First Nations-led treatment facility. The prevalence of ACEs was higher than national averages and previous data collected with broader Indigenous samples in Canada. Descriptive analyses of ACEs and health outcomes for those seeking First Nations-led substance use treatment showed these participants had more chronic health difficulties co-morbid with clinical levels of problematic substance use. To improve ongoing best-treatment options for those seeking substance use treatment, continued assessment and promotion of broader aspects of health and wellbeing are required, including the balance of physical, emotional, spiritual, and mental health and wellbeing across a lifespan. [ABSTRACT FROM AUTHOR]

At the time of planning ALSPAC there was accumulating evidence that abuse and other childhood traumas were related to psychiatric problems later in life. In addition, the age at which such trauma occurred was likely to be important in influencing its long-term impact. Detailed data was therefore collected from enrolled women on traumatic events occurring during their own childhoods, along with their age at the time. The questionnaire entitled ‘About Yourself’ was sent out to expectant women who had enrolled in the study, which included a page in the form of a grid (an events diary) with one row per year of childhood and columns for recording where she was living at the time, who was looking after her, and any traumatic events that occurred. These free-text responses were then coded, and any events were assigned a score indicating the level of trauma the event was likely to have caused on a scale of 1 (highly traumatic) to 6 (least traumatic). This paper describes the variety of text data collected and how it was coded. The ALSPAC study has a great deal of follow-up data collected on the original respondents, as well as on their parents and grandparents, partners, offspring and their grandchildren, providing huge potential for analyses on the antecedents and outcomes of adverse childhood events across multiple generations.

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]

At the time of planning ALSPAC there was accumulating evidence that abuse and other childhood traumas were related to psychiatric problems later in life. In addition, the age at which such trauma occurred was likely to be important in influencing its long-term impact. Detailed data was therefore collected from enrolled women on traumatic events occurring during their own childhoods, along with their age at the time. The questionnaire entitled ‘About Yourself’ was sent out to expectant women who had enrolled in the study, which included a page in the form of a grid (an events diary) with one row per year of childhood and columns for recording where she was living at the time, who was looking after her, and any traumatic events that occurred. These free-text responses were then coded, and any events were assigned a score indicating the level of trauma the event was likely to have caused on a scale of 1 (highly traumatic) to 6 (least traumatic). This paper describes the variety of text data collected and how it was coded. The ALSPAC study has a great deal of follow-up data collected on the original respondents, as well as on their parents and grandparents, partners, offspring and their grandchildren, providing huge potential for analyses on the antecedents and outcomes of adverse childhood events across multiple generations.

Le vécu d'ACEs (Adverse Childhood Experiences) est à ce jour considéré comme un déterminant majeur dans la survenue à l'âge adulte de problématiques de santé physiques et psychologiques. Malgré le caractère prolifique de ce domaine de recherche, un certain nombre de flous conceptuels subsistent, dont témoignent notamment l'absence de définition claire des ACEs ou encore leur appellation dans la littérature. Cette faiblesse conceptuelle a des conséquences pour l'étude, non seulement de la gamme d'adversités à considérer et les paramètres à prendre compte (i.e., gravité, temporalité, durée), mais aussi en ce qui concerne les dysfonctionnements qui découlent de cette adversité. Au-delà de l'impact sur la compréhension de ce qu'est ou n'est pas un vécu d'adversité, ces flous rendent particulièrement délicats son évaluation, le recueil de données sur la base de critères suffisamment homogènes, ainsi que l'espoir d'une prévention efficiente. En effet, si l'on veut agir sur les maux de l'adversité, il convient de circonscrire l'objet pour mieux comprendre ses modalités d'expression, ses déterminants et ses conséquences sur la santé. L'objectif de cet article sera de proposer un état des lieux des différentes compréhensions de l'adversité pour clarifier ce concept. Dans le cadre de ce travail, nous avons souhaité nous focaliser sur deux axes principaux, le premier relatif à l'identification du contexte d'émergence des travaux sur les ACEs et le second qui concernera la question au combien crucial de leur conceptualisation. Adverse childhood experiences (ACEs) have been consistently linked with negative physical and mental health outcomes in adulthood. Despite decades of research dedicated this phenomenon, certain inconsistency exists in the literature regarding how ACEs are conceptually defined. This lack of clarification can impact study outcomes, not only in terms of the range of adversities to be considered and parameters to account for (i.e., severity, temporality, duration), but also with regard to the nature of dysfunctions that result from ACEs. Beyond impacting our overall understanding of what adverse experiences encompass, this obscurity concerning their operational definition complicates how they are assessed, the process of collecting data based on homogeneous criteria and ultimately can hinder effective prevention. Indeed, any meaningful advancement towards treating illness associated with ACEs will require more rigorous definition of ACEs to better understand how they manifest and their specific impact on health outcomes. Our objective in this article is to propose a comprehensive inventory of existing definitions of adversity with a view to clarifying this concept. Within the framework of that objective, we focused on two principal axes: the context of the emerging work on ACEs and the critical question of how ACEs are conceptually defined. [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]

Despite the known impact of exposure to adversity on academic outcomes, the role of adversity, particularly expanded forms of adversity, is overlooked within school discipline. Disproportionate application of exclusionary discipline is known to feed disparate educational and criminal justice pathways, particularly for Black and Indigenous males. The objective of this constructivist grounded theory study was to understand the experiences and needs of students who have been suspended or expelled, to inform practice and policy in education. The following research question was addressed: (1) What situations, supports or experiences have positively or negatively influenced the academic journey of students who have been suspended or expelled? Participants (n = 31) were recruited through suspension and expulsion programs in two school boards in urban and urban emergent areas of Ontario. Fifteen students, aged 14–19, were interviewed, (male, n = 11; Black, n = 10) and 16 multidisciplinary staff. Data were collected through semi-structured interviews and analyzed through constructivist grounded theory methodology. Three interconnected themes, exposure to adversity, connection, and access to resources emerged as influencing students who have been suspended or expelled. Exposure to adversity negatively impacted school success, reinforcing biased perspectives of students, blocking connection, and influencing access to resources throughout students' education, including at the point of discipline. The findings point towards the importance of explicit trauma-informed and culturally aware policy that fosters connection and ensures adequate resources for schools, communities, and students most impacted by expanded forms of adversity. [ABSTRACT FROM AUTHOR]

Potentially traumatic experiences have been associated with chronic diseases. Epigenetic mechanisms, including DNA methylation (DNAm), have been proposed as an explanation for this association. We examined the association of experiences of trauma with epigenome-wide DNAm among African American mothers (n = 236) and their children aged 3–5 years (n = 232; N = 500), using the Life Events Checklist-5 (LEC) and Traumatic Events Screening Inventory—Parent Report Revised (TESI-PRR). We identified no DNAm sites significantly associated with potentially traumatic experience scores in mothers. One CpG site on the ENOX1 gene was methylome-wide-significant in children (FDR-corrected q-value = 0.05) from the TESI-PRR. This protein-coding gene is associated with mental illness, including unipolar depression, bipolar, and schizophrenia. Future research should further examine the associations between childhood trauma, DNAm, and health outcomes among this understudied and high-risk group. Findings from such longitudinal research may inform clinical and translational approaches to prevent adverse health outcomes associated with epigenetic changes. [ABSTRACT FROM AUTHOR]

Introduction: Adverse childhood experiences (ACEs) are widely prevalent and interrelated. They affect multiple domains of health while having a dose–response effect. These effects are biologically plausible, where ACEs are found to be highly associated with physical and mental comorbidities. Objectives: The study aimed to measure the magnitude of ACE and its relationship to mental and physical illnesses in the Eastern Region of Saudi Arabia by assessing its prevalence. Materials and Methods: This was a retrospective cohort study that took place in the Eastern Region of Saudi Arabia in 2020. Setting: It was applied to a population‐based, random adult sample from both genders, different educational levels and socioeconomic statuses. Participants: Those who were 19 years old and above and living in the Eastern region were included. Everyone under the age of 19, those not currently living in the Eastern Region, and those who did not complete the questionnaire were excluded. Results: The total sample size was 611 respondents, but after applying the exclusion criteria, 507 respondents were included. Most participants were females (65.1%). The mean age of the participants was 29.7 years, with a standard deviation of 11.2 years. Regarding educational level, 69.6% were college/university graduates. Most study respondents (81.8%) were exposed to four or more types of ACEs, with emotional neglect being the most common type (82.2%). Having four or more ACEs increases the risk of having physical illnesses compared to those with only one. Furthermore, female respondents who had four or more ACEs had the highest likelihood of having depressed mood (Adjusted odds ratio [AOR] = 1.04; 95% confidence interval [CI] = 1.0–1.07), stress (AOR = 2.8; 95% CI = 1.11–7.3), and insomnia (AOR = 1.04, 95% CI = 1.01–1.07). Conclusion: Our study showed that in the Eastern Region, ACEs are highly prevalent and are associated with an increased risk of mental and physical illness. [ABSTRACT FROM AUTHOR]

Abstract Introduction Adverse childhood experiences (ACEs) are widely prevalent and interrelated. They affect multiple domains of health while having a dose–response effect. These effects are biologically plausible, where ACEs are found to be highly associated with physical and mental comorbidities. Objectives The study aimed to measure the magnitude of ACE and its relationship to mental and physical illnesses in the Eastern Region of Saudi Arabia by assessing its prevalence. Materials and Methods This was a retrospective cohort study that took place in the Eastern Region of Saudi Arabia in 2020. Setting It was applied to a population‐based, random adult sample from both genders, different educational levels and socioeconomic statuses. Participants Those who were 19 years old and above and living in the Eastern region were included. Everyone under the age of 19, those not currently living in the Eastern Region, and those who did not complete the questionnaire were excluded. Results The total sample size was 611 respondents, but after applying the exclusion criteria, 507 respondents were included. Most participants were females (65.1%). The mean age of the participants was 29.7 years, with a standard deviation of 11.2 years. Regarding educational level, 69.6% were college/university graduates. Most study respondents (81.8%) were exposed to four or more types of ACEs, with emotional neglect being the most common type (82.2%). Having four or more ACEs increases the risk of having physical illnesses compared to those with only one. Furthermore, female respondents who had four or more ACEs had the highest likelihood of having depressed mood (Adjusted odds ratio [AOR] = 1.04; 95% confidence interval [CI] = 1.0–1.07), stress (AOR = 2.8; 95% CI = 1.11–7.3), and insomnia (AOR = 1.04, 95% CI = 1.01–1.07). Conclusion Our study showed that in the Eastern Region, ACEs are highly prevalent and are associated with an increased risk of mental and physical illness.

Background: Exposure to adversity, trauma, and negative family environments can prematurely shorten telomeres, the protective caps at the ends of chromosomes. Conversely, some evidence indicates that positive environments and psychosocial interventions can buffer the shortening of telomere length (TL). However, most work has examined individual aspects of the family environment as predictive of TL with little work investigating multiple risk and protective factors. Further, most research has not examined parent TL relative to child TL despite its heritability. Objective: In the current study, we examined interparental conflict, positive parenting, alcohol use, adverse childhood experiences (ACEs), and a family-based intervention as predictive of parent TL. We also examined interparental conflict, positive parenting, ACEs, and a family-based intervention as predictive of child TL. Method: Parents and adolescents from a sample of divorced families participated in either a 10-session family-based intervention, the New Beginnings Programme (NBP), or a 2-week active control condition. Approximately six years after the intervention, a subsample of parents (n = 45) and adolescents (n = 41) were assessed for TL. Parents reported on interparental conflict, ACEs, and alcohol use. Children reported on interparental conflict, positive parenting, and ACEs. In separate models, these constructs and the NBP intervention condition were examined as predictors of parent TL and child TL. Results: Findings indicated that the family-based intervention was associated with longer TL in parents. Also, positive parenting was associated with longer TL in children. Conclusions: These findings have important implications for the role of the family and family-based preventive interventions in buffering parent and child biological stress. HIGHLIGHTS Across multiple indices of psychosocial functioning, we found a family-based intervention associated with longer telomere length in parents and positive parenting associated with longer telomere length in children.

Adverse childhood experiences (ACEs) are pervasive and well-recognized as having lasting deleterious effects on the physical and mental health of those who experience them, particularly with accumulated exposure. This study seeks to identify the perspectives of interprofessional health providers on their personal and professional experiences with ACEs, ACEs screening, how to work with people with ACEs, and make recommendations for the field. Sixty-two health professionals and PhD students who completed at least one module of an online course and at least one of the accompanying discussion board sub-prompts. Responses to five course discussion board assignments, each with multiple sub-prompts, were coded to determine and refine major themes and merged with demographic and other background data. From the 561 responses, six themes were identified and used to analyze response patterns. Twenty-nine percent of responses reflected a macro perspective on ACEs; 29 % of responses reflected workplace experiences; 28 % of responses reflected ACEs complexity, 8 % of responses reflected a personal relationship to ACEs, 3 % reflected perspectives on resilience; and 3 % were related to the course. Participants communicated complex understandings of ACEs, demonstrating the relevance and importance of the topic for public health training. Integrating ACEs training into the practice setting provides opportunities to improve the health and lives of those suffering from ACEs, especially when incorporating provider voice and perspectives. [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]

Background: Exposure to adversity, trauma, and negative family environments can prematurely shorten telomeres, the protective caps at the ends of chromosomes. Conversely, some evidence indicates that positive environments and psychosocial interventions can buffer the shortening of telomere length (TL). However, most work has examined individual aspects of the family environment as predictive of TL with little work investigating multiple risk and protective factors. Further, most research has not examined parent TL relative to child TL despite its heritability. Objective: In the current study, we examined interparental conflict, positive parenting, alcohol use, adverse childhood experiences (ACEs), and a family-based intervention as predictive of parent TL. We also examined interparental conflict, positive parenting, ACEs, and a family-based intervention as predictive of child TL. Method: Parents and adolescents from a sample of divorced families participated in either a 10-session family-based intervention, the New Beginnings Programme (NBP), or a 2-week active control condition. Approximately six years after the intervention, a subsample of parents (n = 45) and adolescents (n = 41) were assessed for TL. Parents reported on interparental conflict, ACEs, and alcohol use. Children reported on interparental conflict, positive parenting, and ACEs. In separate models, these constructs and the NBP intervention condition were examined as predictors of parent TL and child TL. Results: Findings indicated that the family-based intervention was associated with longer TL in parents. Also, positive parenting was associated with longer TL in children. Conclusions: These findings have important implications for the role of the family and family-based preventive interventions in buffering parent and child biological stress. Across multiple indices of psychosocial functioning, we found a family-based intervention associated with longer telomere length in parents and positive parenting associated with longer telomere length in children. [ABSTRACT FROM AUTHOR]

Objective: To determine the prevalence of adverse childhood experiences (ACEs) and healthcare utilization patterns of children seen in pediatric emergency departments (PEDs).Study Design: In this cross-sectional study, caregivers of patients who presented to 2 urban PEDs completed a survey regarding their children's ACEs, health care utilization patterns, and acceptance of PED-based ACEs screening and resources. Inclusion criteria were English-speaking caregivers of patients 0-17 years of age not requiring acute stabilization. Prevalence estimates were compared with national and state data from the National Survey of Children's Health by calculating risk differences and 95% CIs. The association of cumulative ACEs with caregiver-reported health care utilization patterns was evaluated using ORs.Results: Among 1000 participants, 28.1% (95% CI 25.3-30.9) had 1 ACE; 17.8% (95% CI15.4-20.2) had ≥2 ACEs. Notably, children with higher cumulative ACEs were seen in the PED more frequently (0, 1, ≥2 visits) (OR 1.18, 95% CI 1.06-1.30, P = .002) and more likely to seek care in PEDs for sick visits (OR 1.16, 95% CI 1.04-1.30, P = .01). About 9% of children exposed to ACEs did not have a primary care provider. Over 85% of caregivers reported never discussing ACEs with their primary care provider. Most caregivers felt comfortable addressing ACEs in PEDs (84.4%) and would use referral resources (90.4%).Conclusions: Given higher PED utilization in children with more ACEs and caregiver acceptance of PED-based screening and intervention, PEDs may represent a strategic and opportune setting to both assess and respond to ACEs among vulnerable populations. [ABSTRACT FROM AUTHOR]

Adverse childhood experiences (ACEs) and related approaches are receiving increasing focus from education policy makers and educational psychologists. However, the extent to which ACEs research and theory can be used to inform practice continues to be a topic for debate. The present paper explores the development of ACE-informed practice within two UK local authority educational psychology services, through use of focus groups and interviews with educational psychologists. Rationale, facilitators and barriers to the development of current ACE-informed practice are reported. Implications for educational psychology practice, including consideration of risk and reliance factors, the importance of consistent implementation of approaches, and future research are also considered. [ABSTRACT FROM AUTHOR]

A recent special issue of this journal focussed on the emergence of the Adverse Childhood Experiences (ACEs) movement as a key driver of Scottish social policy. In this article, we extend the critiques advanced therein by locating ACEs within a wider cultural turn towards psychological trauma which, over the past decade, has become reified as a master theory across social welfare. Yet, the concept is insubstantial and ill-defined, and the claims made for policy based upon it are at best disputable. Its prominence is less evidence-based than it is testimony to how a particular (cultural and professional) ideology, regardless of its intellectual merit, can be insinuated into policy discourse. ACEs, we suggest, is utilised to provide the trauma paradigm with some ostensibly quantifiable substance. We illustrate our argument through reference to the Scottish Government's National Trauma Training Programme (2020). We go on to consider some of the implications of such ideological capture for the direction of Scottish social welfare policy and practice. The prominence given to trauma perspectives has potentially iatrogenic consequences for those identified or self-identifying as traumatised. At a wider level, it reflects a professional and epistemic privileging of a narrow, ostensibly therapeutic, worldview which, in turn, acts to marginalise 'the social' that characterised erstwhile Scottish approaches to welfare. [ABSTRACT FROM AUTHOR]

Recently published research has revealed that people with Autism Spectrum Disorder (ASD) are more likely to have multiple adverse childhood experiences (ACEs) than neurotypical peers. Little is known however about how such traumas and ASD are associated, the impact of ACEs on people with ASD and their families, and how such comorbidities are best treated. The purpose of the current review was to broadly summarize current literature across disciplines related to adverse childhood or traumatic experiences and ASD. Articles included in this review were: (a) published in peer-reviewed journals between 2008 and 2018, (b) available in English, and (c) included the terms, ACEs, adversity or trauma, and autism. Forty-five articles met search criteria and are presented by theme. Themes include; ACEs and ASD, Trauma and ASD, Trauma and ASD traits, Prenatal Risk, Caretaker Burden and Resilience, and Providing Services. Results indicate that trauma may have cumulative lifelong and intergenerational impacts on people with ASD and their families. Treatment recommendations and adaptations to evidence-based interventions for this population were largely speculative and need further development and rigorous evaluation. Clinical recommendations are cautiously presented, and focus on prevention of cumulative trauma in people with ASD and their families across the lifespan. [ABSTRACT FROM AUTHOR]

Teachers regularly find themselves in situations when they are dealing with students who have experienced adverse childhood experiences (ACES) and trauma. In a survey of public school K-12 teachers in a New England school district, this article analyzes their trauma-related knowledge, skills and needs. While they feel they are doing the best they can, most do not have formal training on how to identify trauma in students or how best to address it. Most indicate that they do not have sufficient background in trauma identification, prevention or treatment and they feel they would benefit from it. Building trauma-informed schools will provide both teachers and students with greater supports and systems for more successfully addressing the traumas they carry. [ABSTRACT FROM AUTHOR]

Background: A growing literature, mostly based on selected populations, indicates that traumas may be associated with autoimmune diseases, yet few studies exist on adverse childhood experiences (ACEs) and multiple sclerosis (MS) in the general population. Objective: We assessed cross-sectional associations between self-reported ACEs and MS among Icelandic women in the population-based Stress-And-Gene-Analysis (SAGA) cohort. Methods: Participants (n = 27,870; mean age 44.9 years) answered a web-based survey that included the ACE-International Questionnaire and a question about MS diagnosis. Log-linear Poisson regression models estimated MS prevalence ratios and 95% confidence intervals for ACEs adjusted for covariates. Results: 214 women reported having been diagnosed with MS (crude prevalence = 7.7 per 1000). Compared to women without MS, women with MS reported more fatigue, body pain and bladder problems. The average cumulative number of ACEs was 2.1. After adjustment for age, education, childhood deprivation, smoking and depressive symptoms, MS prevalence did not increase with increasing ACEs exposure (PR = 1.00, 95% CI = 0.92, 1.09). Thirteen ACE categories, including abuse, neglect, household dysfunction and violence were not individually or independently associated with MS. Conclusion: Limited by self-reported data and cross-sectional design, results do not consistently support associations between ACEs in the development of MS among adult Icelandic women.

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]

Chronic pain is a highly prevalent and costly issue that often emerges during childhood or adolescence and persists into adulthood. Adverse childhood experiences (ACEs) increase risk for several adverse health conditions, including chronic pain. Recent evidence suggests that parental trauma (ACEs, post-traumatic stress disorder (PTSD) symptoms) confers risk of poor health outcomes in their children. Intergenerational relationships between parental trauma and child chronic pain may be mediated by epigenetic mechanisms. A clinical sample of youth with chronic pain and their parents completed psychometrically sound questionnaires assessing ACEs, PTSD symptoms, and chronic pain, and provided a saliva sample. These were used to investigate the intergenerational relationships between four epigenetic biomarkers (COMT, DRD2, GR, and SERT), trauma, and chronic pain. The results indicated that the significant biomarkers were dependent upon the gender of the child, wherein parental ACEs significantly correlated with changes in DRD2 expression in female children and altered COMT expression in the parents of male children. Additionally, the nature of the ACE (maltreatment vs. household dysfunction) was associated with the specific epigenetic changes. There may be different pathways through which parental ACEs confer risk for poor outcomes for males and females, highlighting the importance of child gender in future investigations. [ABSTRACT FROM AUTHOR]

Potentially traumatic experiences have been associated with chronic diseases. Epigenetic mechanisms, including DNA methylation (DNAm), have been proposed as an explanation for this association. We examined the association of experiences of trauma with epigenome-wide DNAm among African American mothers (n = 236) and their children aged 3–5 years (n = 232; N = 500), using the Life Events Checklist-5 (LEC) and Traumatic Events Screening Inventory—Parent Report Revised (TESI-PRR). We identified no DNAm sites significantly associated with potentially traumatic experience scores in mothers. One CpG site on the ENOX1 gene was methylome-wide-significant in children (FDR-corrected q-value = 0.05) from the TESI-PRR. This protein-coding gene is associated with mental illness, including unipolar depression, bipolar, and schizophrenia. Future research should further examine the associations between childhood trauma, DNAm, and health outcomes among this understudied and high-risk group. Findings from such longitudinal research may inform clinical and translational approaches to prevent adverse health outcomes associated with epigenetic changes.

Child maltreatment and other adverse childhood experiences (ACEs) often cooccur and are related to negative socioemotional outcomes; however, limited research differentiates how maltreatment versus other ACEs predict such outcomes. These efforts are necessary to determine whether cumulative ACE screening efforts best predict those at risk for poor outcomes. We examined cumulative childhood ACEs, cumulative maltreatment subtypes, and adult attachment quality in 379 young and middle-aged adults. This sample enabled comparison between emerging adults and older adults who have navigated additional developmental tasks that may counteract the effects of early ACEs. More ACEs and maltreatment experiences predicted insecure anxious, avoidant, and fearful attachment styles; however, maltreatment failed to predict unique variance in attachment quality beyond other ACEs. Results suggest that maltreatment may be best categorized as part of a general cumulative risk profile predicting poor socioemotional outcomes. Findings support burgeoning trends in medical and social service settings assessing ACEs using simple dichotomous screening tools to identify those requiring intervention and support services. [ABSTRACT FROM AUTHOR]

Childhood adversity is strongly associated with poor health and well-being in childhood and adulthood. Young children are at greatest risk during their developmental years. Child care providers can participate in preventing the impact of adversity on children by becoming communities of support for families in need. This project aimed to explore the feasibility and acceptability of identifying childhood adversity and strengthening family protective factors by incorporating professional development and both universal and targeted interventions that included screening, motivational interviewing, parent cafés, and parenting workshops within ten family and center-based child care programs. A total of 159 caregivers completed the screen about their experiences of adversity, with 60% disclosing adversity during their childhood and 53% disclosing current risk for adversity for their child. An intergenerational association was found between caregivers' past exposure to adversity and their child's current risk (p = 0.023). However, this association was no longer significant (p = 0.14) when accounting for their current protective factors (p = 0.002). Most families (77%) who disclosed moderate to high adversity or risk on the screen participated in a brief interview with their child care provider. Eleven parent events were also conducted with an attendance of 91. Child care providers reported that these interventions were both feasible and beneficial. Caregivers showed significant improvements in protective factors (p = 0.013) over the course of the project. [ABSTRACT FROM AUTHOR]

Adverse babyhood experiences (ABEs) identify 10 categories of negative events for mothers before they conceive, and for parents and babies from conception until a child's third birthday. ABEs identify preventable and reducible non-genetic factors that increase risk for infant morbidity and mortality, chronic illness, mental health conditions, and other symptoms in a child's life; morbidity and mortality in mothers; PTSD and depression in fathers, and more. Understanding, repairing, and reversing effects of ABEs decreases risk for adverse childhood experiences (ACEs), and for poor health outcomes in parents and children. [ABSTRACT FROM AUTHOR]