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Aims: Secondary trauma is recognised as one of the negative effects for professionals working with people that have experienced trauma. Research has demonstrated secondary trauma in foster carers but little research has explored trauma symptoms within adoptive parents, facing the emotional impact of parenting a child with adverse early experiences. This study aimed to document the rates of primary and secondary trauma symptoms in adoptive parents. It further explores the association between the extent of current behavioural and emotional challenges and the extent of the child's pre-adoption adverse experiences in predicting parental trauma responses. Method: 190 adoptive parents completed an online survey including self-report measures of primary and secondary trauma. Results: Almost one fifth of adoptive parents exhibited primary trauma scores of clinical concern; with 10% reaching the threshold for a probable diagnosis of PTSD. Participants also reported significantly higher levels of secondary trauma and burnout, and significantly lower levels of compassion satisfaction than population norms. The current behavioural and emotional challenges, including child-to-parent violence, predicted higher trauma scores more so than the extent of their child's past adverse experiences. Conclusions: The findings have clinical implications for identifying trauma symptoms within adoptive parents and wider implications for how we understand secondary and primary trauma. They further highlight the importance of firstly addressing current child behaviour, including child-to-parent violence when treating trauma symptoms. Limitations of this study and recommendations for further research are discussed. Plain language summary: Aims: This study aimed to explore primary and secondary trauma symptoms in adoptive parents. It further explores the impact of current behavioural and emotional challenges and the impact of the child's pre-adoption adverse experiences in predicting parental trauma responses. Method: 190 adoptive parents completed an online survey including self-report measures of primary and secondary trauma. Results: Almost one fifth of adoptive parents exhibited primary trauma scores of clinical concern; with 10% reaching the threshold for a probable diagnosis of PTSD. The current behavioural and emotional challenges, including child-to-parent violence, predicted higher trauma scores more so than the extent of their child's past adverse experiences. Conclusions: The findings have clinical implications for identifying trauma symptoms within adoptive parents. They further highlight the importance of firstly addressing current child behaviour, including child-to-parent violence when treating trauma symptoms. Limitations of this study and recommendations for further research are discussed. [ABSTRACT FROM AUTHOR]

An understanding of the prevalence and risk factors of parental mental health problems is important for early intervention and prevention measures and shaping services for parents and their children. However, large representative surveys of parental mental health problems and associated risk factors are lacking. The aim of this study was to estimate prevalence rates of parental mental health problems using a standardised measure of psychiatric morbidity (General Health Questionnaire; GHQ‐12), in a representative sample of parents and caregivers of children and young people (2–19 years) in Northern Ireland. Further, this study explored associated risk factors of parental mental health problems. A random household survey of parents and children was conducted between June 2019 and March 2020. Parental responses on demographic, economic, familial and psychological measures were collected (N = 2815) and 22% of parents and caregivers screened positive for mental health problems. The STROBE checklist for observational research was adhered to. Multivariate logistic regression indicated that being in receipt of benefits, having poor family support, a history of adverse childhood experiences, a history of exposure to politically motivated violence (the Troubles), and a child with conduct problems and poor health were all independent risk factors of increased parental mental health problems. Findings will help to inform future commissioning and development of services and broaden understanding of the correlates of parental mental health problems. [ABSTRACT FROM AUTHOR]

Past research suggests that children from two-parent married families fare better than children from other families on many outcomes. Only fragmented evidence on diverse family trajectories in association with child mental health is available. Using multi-channel sequence analysis and data from the UK Household Longitudinal Study, we jointly capture maternal partnership trajectories and type of father co-residence between birth and age 5. We then assess the association between these family trajectories and child mental health at age 5 and 8 using random effects regression. Children whose trajectories include the entrance of a non-biological father or parental separation have the lowest levels of mental health. However, children of never partnered mothers and those who repartner with the biological father have comparable mental health to children of stably married biological parents. Thus, not all types of family complexity or instability appear to be equally detrimental to children's mental health. [ABSTRACT FROM AUTHOR]

Adverse childhood experiences (ACEs) are widely recognized as associated with stress-associated digestive disorders, yet their comprehensive relationship with gastro-esophageal diseases as well as the potential mechanisms of depression remains underexplored. The prospective study included 133,638 participants aged 40–69 from UK Biobank with full information on ACEs, depression, and gastro-esophageal diseases. ACEs were retrospectively measured both as individual types (physical, emotional, and sexual abuse, and physical and emotional neglect) and cumulative scores of experienced types. Cox proportional hazards model was utilized to assess the association of ACEs with the overall and type-specific risks of diseases. Two-sample Mendelian randomization (TSMR) was conducted utilizing data from a genome-wide association study of ACEs (N = 185,414) to further examine the causal relationship. Mediation analysis was performed to quantify the role of depression. During a median follow-up of 13.3 years, those who had a history of ACEs were observed with a 15 % higher overall risk of gastro-esophageal diseases (HR, 1.15; 95%CI, 1.12–1.19) and 10–25 % increased type-specific risks compared to unexposed participants. Among five individual types of ACEs, the association was more prominent for emotional abuse (1.22, 1.17–1.27) and sexual abuse (1.24, 1.18–1.30). TSMR analysis consistently reported positive associations between ACE and four subtypes of gastro-esophageal diseases. Depression was found to mediate 17.2 % (13.5 %, 24.0 %) of the aforementioned relationship. Our findings highlight the importance of early screening and intervention on ACEs to reduce the long-term risk of gastro-esophageal diseases, and stress the potential of depression as a ponderable indirect intervention target. • Adverse childhood experiences are associated with gastro-esophageal diseases risks. • Emotional and sexual abuse show more prominent association among all childhood adversity types. • Depression partly mediates the link between childhood adversities and gastro-esophageal diseases. [ABSTRACT FROM AUTHOR]

Both adverse childhood experiences (ACEs) and lifestyle factors have been associated with risk of cardiovascular diseases (CVDs) in later life, but whether and to what extent adherence to a healthy lifestyle in adulthood can offset the increased cardiovascular risk associated with ACEs is unclear. We aimed to determine whether and to what extent adopting to a healthy lifestyle in adulthood can offset the risk of CVDs in individuals according to their ACEs. A prospective cohort study included 143,869 participants aged 38–72 years, free of CVDs at baseline from the UK Biobank. The history of ACEs was assessed using the Childhood Trauma Screener. Participants were divided into three risk groups based on ACEs: low (no ACEs), intermediate (one or two ACEs), and high (three or more ACEs). A healthy lifestyle score in adulthood was constructed as the sum of four modifiable lifestyle factors (no smoking, adequate physical activity, healthy diet, no obesity), and participants were then categorized into three groups based on this score (unfavorable [0–1 point], intermediate [2–3 points], favorable [4 points]). Cox proportional hazard models were conducted to investigate the association between ACEs, healthy lifestyle, and incident CVDs. During a median follow-up of 12.49 years, 13,373 incident cases of overall CVDs were identified. This included 7521 cases of coronary heart disease (CHD), 6175 cases of atrial fibrillation (AF) and 1813 cases of stroke. Individuals with high ACEs had a greater risk of incident overall CVDs (hazard ratio [HR] = 1.39, [95%CI = 1.29 to 1.50]), CHD (1.50 [1.36 to 1.65]) and AF (1.18 [1.05 to 1.33]) compared to those with low ACEs. The risk of CVDs decreased moving from unfavorable to favorable lifestyle categories (P for trend<0.001), with the lowest risk observed among individuals with a favorable lifestyle (0.70 [0.66 to 0.74] for overall CVDs, 0.69 [0.64 to 0.75] for CHD, and 0.71 [0.65 to 0.78] for AF). Participants with high ACEs and a favorable lifestyle had a 39 %, 40 % and 47 % lower risk of developing overall CVDs (0.61 [0.48 to 0.76]), CHD (0.60 [0.44 to 0.81], and AF (0.53 [0.36 to 0.77]) than those with high ACEs and an unfavorable lifestyle. Having a healthy lifestyle in adulthood could substantially attenuate the increased risk of overall CVDs, CHD, and AF conferred by ACEs. • Adverse childhood experiences (ACEs) independently increased the risk of incident cardiovascular diseases (CVDs). • Adopting a healthy lifestyle was significantly associated with a decreased risk of CVDs, regardless of ACEs category. • While exposure to ACEs is unmodifiable, the potential CVD risk can be significantly reduced by adopting a healthy lifestyle. [ABSTRACT FROM AUTHOR]

Background: Adverse childhood experiences (ACEs) are well‐established risk factors for self‐harm and depression. However, despite their high comorbidity, there has been little focus on the impact of developmental timing and the duration of exposure to ACEs on co‐occurring self‐harm and depression. Methods: Data were utilised from over 22,000 children and adolescents participating in three UK cohorts, followed up longitudinally for 14–18 years: the Avon Longitudinal Study of Parents and Children (ALSPAC), the Millennium Cohort Study (MCS) and the Environmental Risk (E‐Risk) Longitudinal Twin Study. Multinomial logistic regression models estimated associations between each ACE type and a four‐category outcome: no self‐harm or depression, self‐harm alone, depression alone and self‐harm with co‐occurring depression. A structured life course modelling approach was used to examine whether the accumulation (duration) of exposure to each ACE, or a critical period (timing of ACEs) had the strongest effects on self‐harm and depression in adolescence. Results: The majority of ACEs were associated with co‐occurring self‐harm and depression, with consistent findings across cohorts. The importance of timing and duration of ACEs differed across ACEs and across cohorts. For parental mental health problems, longer duration of exposure was strongly associated with co‐occurring self‐harm and depression in both ALSPAC (adjusted OR: 1.18, 95% CI: 1.10–1.25) and MCS (1.18, 1.11–1.26) cohorts. For other ACEs in ALSPAC, exposure in middle childhood was most strongly associated with co‐occurring self‐harm and depression, and ACE occurrence in early childhood and adolescence was more important in the MCS. Conclusions: Efforts to mitigate the impact of ACEs should start in early life with continued support throughout childhood, to prevent long‐term exposure to ACEs contributing to risk of self‐harm and depression in adolescence. [ABSTRACT FROM AUTHOR]

Background: Children with developmental language disorder (DLD) experience higher levels of peer victimization than their peers. However, it is not known if such associations reflect genetic and environmental confounding. We used a co‐twin control design to investigate the association of language difficulties (DLD and separately poor pragmatic language) with peer victimization and compare the developmental trajectories of peer victimization across adolescence for those with and without language difficulties. Methods: Participants were 3,400 pairs of twins in the Twins Early Development Study (TEDS), a UK‐based population birth cohort. Language abilities were assessed via online tests at age 11 and peer victimization was self‐reported at ages 11, 14 and 16. Language difficulties were defined as language abilities at least −1.25 SD below the mean of the TEDS sample. We performed linear regressions and latent growth curve modeling at a population level and within monozygotic and same‐sex dizygotic twin pairs. Results: At population level, youth with DLD experienced higher levels of peer victimization at ages 11 (β = 0.27, 95% Confidence Interval (CI) 0.20–0.35), 14 (β = 0.15, 95% CI 0.03–0.27) and 16 (β = 0.17, 95% CI 0.03–0.32) and a sharper decline in peer victimization between ages 11 and 16 compared to their peers without DLD. The associations between DLD and peer victimization were reduced in strength and not statistically significant in within‐twin models. Moreover, there was no difference in the rate of change in peer victimization between twin pairs discordant for DLD. Results were similar for the association of poor pragmatic language with peer victimization. Conclusions: Associations between language difficulties (DLD and separately, poor pragmatic language) and peer victimization were confounded by genetic and shared environmental factors. Identifying specific factors underlying these associations is important for guiding future work to reduce peer victimization among adolescents with language difficulties. [ABSTRACT FROM AUTHOR]

Emotional support from family members may have an important effect on adolescent health outcomes, and has been identified as a target for policy to protect against the impacts of poverty and other early life adversities. However, few studies have assessed the extent to which poverty and adversity themselves influence the nature of emotional support that parents can provide to adolescents. We, therefore, aimed to investigate the impact of trajectories of income poverty and family adversities, including parental mental ill health, alcohol misuse and domestic violence across childhood developmental stages on young people's relationships with their families and perceived emotional support received. We analysed longitudinal data on 10,976 children from the nationally representative UK Millennium Cohort study. Exposure trajectories of poverty and family adversities were characterised using group-based multi-trajectory models (age 9 months–14 years). The outcomes were perceived emotional support and quality of family relationships, measured by the three-item Short Social Provisions Scale (SPS-3) and levels of parent–adolescent closeness and conflict, measured at age 14. ORs and 95% CIs were estimated using multivariable logistic regression models, adjusting for potential confounding factors. At age 14, the overall prevalence of low perceived emotional support was 13% (95% CI: 12, 14). Children of mothers with lower socioeconomic status (SES) were more likely to report low emotional support, with a clear social gradient (education—degree plus: 10.3% vs. no qualifications: 15.4%). Compared with children exposed to low levels of poverty and adversity, children in the persistent adversity trajectory groups experienced higher odds of low emotional support and low-quality parent–adolescent relationship; those exposed to both persistent poverty and poor parental mental health were particularly at increased risk of experiencing poor family relationships and low perceived emotional support (adjusted odds ratio 2·2; 95% CI 1·7–2·9). Low perceived emotional support and poor family relationships in adolescence are more prevalent among socially disadvantaged children and adolescents and those experiencing social adversity. Policies to improve levels of family support for UK adolescents should focus on improving modifiable determinants such as child poverty and family mental health. [ABSTRACT FROM AUTHOR]

Children growing up with a parent with mental ill-health are a hidden and vulnerable group. Positioned at the intersection between adult and children services, and health and social care, these children fall between the gaps, rarely acknowledged in policy or practice. This is exacerbated when the young person is excluded under the auspices of patient confidentiality and age appropriateness. This article reports findings from research which captured young carers' retrospective accounts of professional support when caring for a parent with mental illness. Participants in this research study described being 'involved but not included'; they provided significant care to their parent and were relied on by professionals to provide support. However, they were simultaneously omitted from any discussion or understanding of the decisions made. This article explores the relevance of these accounts for current service provision. It concludes with recommendations for involving young carers in care planning and ensuring that young carers have their own needs assessed and acknowledged by professionals. [ABSTRACT FROM AUTHOR]

Childhood trauma was known to increase risks of social isolation, loneliness and self-injurious thoughts and behaviors in adulthood. The aim of this study was to examine the protect and risk factors of social health, self-injurious thoughts and behaviors between adults with or without childhood trauma. This was a cross-sectional study comprising of 145,043 participants enrolled in the UK Biobank. Childhood trauma was determined by the Childhood Trauma Screener. Social health included social isolation, loneliness and emotional support. Outcomes of self-injurious thoughts and behaviors included suicide ideation, suicide attempt and non-suicidal self-injury (NSSI). Demographic data, self-reported morbidities and other confounding variables were covariates. Stata 17.0 and SPSS 27.0 was used to analysis data. Compared with participants without childhood trauma, there was no protective effect of emotional support for NSSI in participants with childhood trauma (β -value difference = 0.334, p = 0.008). The risk effect of loneliness for suicide ideation, suicide attempt and NSSI were also weaker in participants experiencing childhood trauma (p <0.05). Social isolation was no longer a risk factor for NSSI in all participants, while loneliness remained as a threat (p < 0.05). Many variables were measured using core items of the scale in UK Biobank, meanwhile, the childhood trauma data collected in adulthood may have recall bias. Adults reported childhood trauma were less vulnerable to self-injurious thoughts and behaviors when experiencing loneliness, but they could also not be protected from NSSI through emotional support. Emotional dysregulation caused by childhood trauma may contribute to this. • Adults reported childhood trauma were less vulnerable to self-injurious thoughts and behaviors when experiencing loneliness; • Adults reported childhood trauma would not be protected from NSSI through emotional support. • Regardless of childhood trauma, social isolation was not a risk factor for NSSI, while loneliness remained as a threat. [ABSTRACT FROM AUTHOR]

Background Youth adversity is associated with persistence of depression and anxiety symptoms. This association may be greater for disadvantaged societal groups (such as females) compared with advantaged groups (e.g. males). Given that persistent symptoms are observed across a range of disadvantaged, minoritized, and neurodivergent groups (e.g. low compared with high socio-economic status [SES]), the intersection of individual characteristics may be an important moderator of inequality. Methods Data from HeadStart Cornwall (N = 4441) was used to assess the effect of youth adversity on combined symptoms of depression and anxiety (Strengths and Difficulties Questionnaire emotional problems subscale) measured at three time-points in 11–14-year-olds. Latent trajectories and regressions were estimated for eight intersectionality profiles (based on gender, SES, and hyperactivity/inattention), and moderating effects of the individual characteristics and their intersections were estimated. Results Youth adversity was associated with higher average depression/anxiety symptoms at baseline (11–12-years) across all intersectionality profiles. The magnitude of effects differed across profiles, with suggestive evidence for a moderating effect of youth adversity on change over time in depression/anxiety symptoms attributable to the intersection between (i) gender and SES; and (ii) gender, SES, and hyperactivity/inattention. Conclusions The detrimental effects of youth adversity pervade across intersectionality profiles. The extent to which these effects are moderated by intersectionality is discussed in terms of operational factors. The current results provide a platform for further research, which is needed to determine the importance of intersectionality as a moderator of youth adversity on the development of depression and anxiety symptoms in adolescence. [ABSTRACT FROM AUTHOR]

Increasing empirical attention has been given to the role of adverse childhood experiences (ACEs) in the development and maintenance of body dysmorphic disorder (BDD). Yet, current research has predominantly focused on adult and nonclinical BDD samples, and little is known about relevance of ACEs in adolescent BDD. The present study examined (a) the frequency of ACEs in adolescents with a primary diagnosis of BDD (n = 50) versus obsessive compulsive disorder (OCD) (n = 50) and (b) the clinical profile of ACE‐exposed youth with BDD. ACEs were ascertained through a systematic search of electronic patient records, as well as through a parent‐ and self‐report screening item for exposure to traumatic events. Results showed higher rate of peer victimisation (74% vs. 38%) and child maltreatment (44% vs. 24%) among BDD versus OCD youths; sexual abuse was the most common type of child maltreatment documented in the BDD group (28%) according to patient records. Parent‐reported exposure to traumatic events was also significantly higher in the BDD than the OCD group (40% vs. 18%, respectively). Clinical presentation and treatment outcomes did not differ between those with versus without a history of ACEs. The current study is the first to demonstrate that a range of ACEs are common in adolescent BDD. Our findings highlight the importance of screening for these experiences. Although further research is needed, our findings also indicate that adolescents with BDD who have a history of ACEs are broadly similar in their clinical presentation to those without, and benefit from BDD‐focused treatment. [ABSTRACT FROM AUTHOR]

Background: Multimorbidity, known as the co-occurrence of at least two chronic conditions, has become of increasing concern in the current context of ageing populations, though it affects all ages. Early life risk factors of multimorbidity include adverse childhood experiences (ACEs), particularly associated with psychological conditions and weight problems. Few studies have considered related mechanisms and focus on old age participants. We are interested in estimating, from young adulthood, the risk of overweight-depression comorbidity related to ACEs while adjusting for early life confounders and intermediate variables. Methods: We used data from the 1958 National Child Development Study, a prospective birth cohort study (N = 18 558). A four-category outcome (no condition, overweight only, depression only and, overweight-depression comorbidity) was constructed at 23, 33, and 42 years. Multinomial logistic regression models adjusting for intermediate variables co-occurring with this outcome were created. ACEs and sex interaction on comorbidity risk was tested. Results: In our study sample (N = 7762), we found that ACEs were associated with overweight-depression comorbidity risk throughout adulthood (RRR [95% CI] at 23y = 3.80 [2.10–6.88]) though less overtime. Comorbidity risk was larger than risk of separate conditions. Intermediate variables explained part of the association. After full-adjustment, an association remained (RRR [95% CI] at 23y = 2.00 [1.08–3.72]). Comorbidity risk related to ACEs differed by sex at 42. Conclusion: Our study provides evidence on the link and potential mechanisms between ACEs and the co-occurrence of mental and physical diseases throughout the life-course. We suggest addressing ACEs in intervention strategies and public policies to go beyond single disease prevention. [ABSTRACT FROM AUTHOR]

Childhood trauma is experienced by approximately one third of young people in the United Kingdom and has been shown to confer an increased risk for mental health difficulties in adulthood. Understanding the associations between these factors before negative health outcomes manifest in adulthood is imperative to help inform the development of interventions. The aims of this study were two-fold; first, to investigate the effects of childhood trauma on daily stress-related vulnerability factors over a period of 7 days and to test whether any observed relationships were moderated by protective or risk factors. Second, to explore the indirect effects of childhood trauma on reasons for living, optimism, daily suicide ideation, defeat and entrapment through the daily stress-related vulnerability factors. 212 participants were recruited to an ecological momentary assessment study to complete three diaries per day for a 7-day period. Participants completed daily measures of stress, hassles, executive functioning, impulsivity, sleep quality (stress-related vulnerability factors) as well as measures of reasons for living, optimism, daily thoughts of suicide, defeat and entrapment. The Childhood Trauma Questionnaire was also completed at baseline. Analyses found that childhood trauma was significantly associated with higher scores on the daily stress-related vulnerability factors and positively related to each of the daily indicators of suicide risk. The study also uncovered key pathways whereby trauma had indirect effects on reasons for living, optimism, daily thoughts of suicide, defeat and entrapment through executive functioning, impulsivity, sleep quality and stress. The measures of executive function and sleep were self-reported and future research ought to replicate the current findings using more objective methods. The findings from this study highlight the complexity of childhood trauma and its damaging effects on stress-related vulnerability factors and poorer mental health outcomes. Greater understanding of pathways by which trauma may impact later health outcomes is essential for development of interventions. • Childhood trauma was associated with higher daily stress and impulsivity. • Childhood trauma was related to poorer sleep quality and executive functioning. • Childhood trauma was associated with suicide risk factors. • Childhood trauma had indirect effects on suicide risk through stress-related variables. [ABSTRACT FROM AUTHOR]

Adult child to parent violence is a growing international social problem that needs to be better understood to develop clinical interventions. An exploratory study on the antecedents of early life adversity on adult child to parent violence/elder mistreatment was carried out using secondary analysis. Directed content analysis was used based on life course theory with a data set of older mothers all > 57 years old (J. R. Smith 2021, 2022). Measurement of instances of child abuse, domestic violence, and birth trauma among abused older mothers was conducted. All the older women had reported being negatively affected by their adult children's problems and 56% reported being physically attacked. A case example is presented to illustrate how repeated incidents of abuse or neglect in early life might explain an older woman's inability to take actions for her own safety. [ABSTRACT FROM AUTHOR]

Background: Adverse childhood experiences (ACEs), including childhood maltreatment, have been linked with increased risk of diabetes and obesity during adulthood. A comprehensive assessment on the associations between childhood maltreatment and all major endocrine diseases, as well as the relative importance of different proposed mechanistic pathways on these associations, is currently lacking. Methods: Based on the UK Biobank, we constructed a cohort including 151,659 participants with self-reported data on childhood maltreatment who were 30 years of age or older on/after January 1, 1985. All participants were followed from the index date (i.e., January 1, 1985, or their 30th birthday, whichever came later) until the first diagnosis of any or specific (12 individual diagnoses and 9 subtypes) endocrine diseases, death, or the end of follow-up (December 31, 2019), whichever occurred first. We used Cox models to examine the association of childhood maltreatment, treated as continuous (i.e., the cumulative number of experienced childhood maltreatment), ordinal (i.e., 0, 1 and ≥ 2), or binary (< 2 and ≥ 2) variable, with any and specific endocrine diseases, adjusted for multiple covariates. We further examined the risk of having multiple endocrine diseases using Linear or Logistic Regression models. Then, sequential mediation analyses were performed to assess the contribution of four possible mechanisms (i.e., suboptimal socioeconomic status (SES), psychological adversities, unfavorable lifestyle, and biological alterations) on the observed associations. Results: During an average follow-up of 30.8 years, 20,885 participants received a diagnosis of endocrine diseases. We observed an association between the cumulative number of experienced childhood maltreatment and increased risk of being diagnosed with any endocrine disease (adjusted hazard ratio (HR) = 1.10, 95% confidence interval 1.09–1.12). The HR was 1.26 (1.22–1.30) when comparing individuals ≥ 2 with those with < 2 experienced childhood maltreatment. We further noted the most pronounced associations for type 2 diabetes (1.40 (1.33–1.48)) and hypothalamic–pituitary–adrenal (HPA)-axis-related endocrine diseases (1.38 (1.17–1.62)), and the association was stronger for having multiple endocrine diseases, compared to having one (odds ratio (95% CI) = 1.24 (1.19–1.30), 1.35 (1.27–1.44), and 1.52 (1.52–1.53) for 1, 2, and ≥ 3, respectively). Sequential mediation analyses showed that the association between childhood maltreatment and endocrine diseases was consistently and most distinctly mediated by psychological adversities (15.38 ~ 44.97%), while unfavorable lifestyle (10.86 ~ 25.32%) was additionally noted for type 2 diabetes whereas suboptimal SES (14.42 ~ 39.33%) for HPA-axis-related endocrine diseases. Conclusions: Our study demonstrates that adverse psychological sequel of childhood maltreatment constitutes the main pathway to multiple endocrine diseases, particularly type 2 diabetes and HPA-axis-related endocrine diseases. Therefore, increased access to evidence-based mental health services may also be pivotal in reducing the risk of endocrine diseases among childhood maltreatment-exposed individuals. [ABSTRACT FROM AUTHOR]

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

Background: Some modifiable risk factors for cancer originate during adolescence. While there is evidence indicating relationships between adverse childhood experiences and health risk behaviours generally, little is known about how childhood adversity influences the engagement of adolescents in cancer risk behaviours. This study aimed to determine the relationship between adverse childhood experiences and adolescent cancer risk behaviours. Methods: Data were collected prospectively from birth to age 18 years on children born to mothers enrolled into the Avon Longitudinal Study of Parents and Children (ALSPAC) cohort study. Multivariable linear regression models assessed relationships of a composite exposure measure comprised of adverse childhood experiences (total number of childhood adversities experienced from early infancy until age 9 years) with multiple cancer risk behaviours. The latter was expressed as a single continuous score for tobacco smoking, alcohol consumption, obesity, unsafe sex, and physical inactivity, at ages 11, 14, 16 and 18 years. Analysis was carried out on the complete case and imputation samples of 1,368 and 7,358 participants respectively. Results: All adolescent cancer risk behaviours increased in prevalence as the adolescents grew older, except for obesity. Each additional adverse childhood experience was associated with a 0.25 unit increase in adolescent cancer risk behaviour (95% CI 0.16–0.34; p < 0.001). Individually, parental substance misuse (β 0.64, 95% CI 0.25–1.03, p < 0.001) and parental separation (β 0.56, 95% CI 0.27–0.86, p < 0.001) demonstrated the strongest evidence of association with engagement in adolescent cancer risk behaviour. Conclusion: Childhood adversity was associated with a greater degree of engagement in adolescent cancer risk behaviours. This finding demonstrates the need for targeted primary and secondary prevention interventions that reduce engagement across multiple cancer risk behaviours for children and adolescents who have experienced adversity in childhood, such as parental substance misuse and separation, and reduce exposure to adversity. [ABSTRACT FROM AUTHOR]

Objective: To examine the association between smoking initiation in adolescence and subsequent different smoking trajectories of people who smoke, and to examine the combined effect of adverse childhood experiences (ACEs) and smoking initiation in adolescence on smoking trajectories of people who smoke. Design and Sample: Data are from 8757 individuals in Great Britain from the birth cohort National Child Development Study and who reported being smokers or former smokers by age 23. Measurements: Smoking initiation in adolescence was measured at 16 y and smoking trajectories were derived from smoking variables from ages 23 to 55. We modelled the relationship between smoking initiation in adolescence with or without ACEs and smoking trajectories. Results: Individuals who initiated smoking in adolescence were more likely to quit later than quitting in twenties (RRR quitting in thirties = 3.43 [2.40; 4.89] p <.001; RRR quitting in forties = 5.25 [3.38; 8.14] p <.001; RRR quitting in fifties = 4.48 [2.95; 6.79] p <.001), to relapse (RRR Relapse = 3.66 [2.82; 4.76] p <.001) and to be persistent smokers (RRR persistent = 5.25 [3.81; 7.25] p <.001) compared to those who had initiated smoking in young adulthood. These effects were particularly pronounced in case of ACEs. Conclusion: Smoking prevention programs aimed at reducing smoking initiation should be promoted to adolescents to limit the burden of smoking, especially for people who have suffered adversity during childhood. [ABSTRACT FROM AUTHOR]

Introduction: The objectives for this study were to explore Black people's experiences of being asked about ACEs by mental health or counselling professionals, both broadly, and also as part of routine enquiry with a commonly used ACE questionnaire. An additional aim was to understand their perspectives on how services should be asking about ACEs. Methods: This study used a qualitative methodology, with a critical realist reflexive thematic analysis approach. Ten people who identified as Black and had been asked about ACEs by a mental health professional or counsellor, were interviewed about their experiences and perspectives using semi‐structured interviews. Results: Four overarching themes, some with subthemes, were established: Trust and safety as individual and systemic (subthemes: Distrust in the system; Distrust in the clinician; Racism in health care; Keeping safe); It is the person, not the questions (subthemes: Being heard and understood; Similarity and difference); Engaged client, 'hard‐to‐reach' clinician? and People are not tick‐boxes. Conclusions: The results highlight that people find it important and useful to be asked about ACEs, if it is done in an appropriate manner. Establishing trust and a therapeutic relationship is key to fostering this. Participants stated that the ACE questionnaire might miss important context, and they relayed a preference for being asked about ACEs using more inclusive definitions of ACEs. [ABSTRACT FROM AUTHOR]

Background: Mental ill-health and obesity are increasingly prevalent in childhood with both conditions likely to co-occur. Less is known about associations between adverse childhood experiences (ACEs) and mental ill-health and obesity (MH-OB) comorbidity in adolescence. The aim of this study was to examine associations between ACEs and MH-OB comorbidity in adolescents from a national cohort study. Methods: Participants; 10,734 adolescents (males = 50.3%) from the Millennium Cohort Study with 6 ACEs (for e.g., parental MH, drug/alcohol misuse, physical punishment) collected prospectively between ages 3-11 years. MH-OB comorbidity (binary indicator) was based on objectively measured BMI (for overweight/obesity) and self-reported depression/anxiety at ages 14 and 17. Associations between: 1.total ACE scores (0, 1, 2 or ≥3) and additionally each individual ACE, and MH-OB, were analysed used logistic regression, separately at 14 and 17 years. Results: At age 14, ACE scores were associated with higher odds for MH-OB comorbidity, with a gradient of increasing odds ratios (OR) with increasing ACEs. Individuals with 1 (OR:1.22[95%CI: 1.1-1.6]), 2 (OR:1.7[1.3-2.3]), or ≥3ACEs (OR:2[1.5-2.6]) had increased odds for MH-OB comorbidity compared to those with 0 ACEs. At age 17, associations between ACE scores and MH-OB were attenuated and observed in individuals with ≥3ACEs (OR:1.54, 1.1-2.3). Parental MH (OR:1.5, 1.2-1.9), intimate-partner violence (OR:1.2, 1.1-1.6), physical punishment (OR:1.3, 1.1-1.6), bullying (OR:2, 1.6-2.5) were associated with MH-OB comorbidity age 14. However, only parental MH (OR:1.5, 1.1-2.1) and bullying (OR:1.6, 1.2-2.1) were associated with MH-OB comorbidity at age 17. Conclusion: ACEs are associated with increased risk of MH-OB comorbidity in between ages 14 and 17. These findings provide timely opportunity for interventions to reduce risk and are pertinent given that MH and obesity contribute significantly to global burden of disease and track across the lifecourse. [ABSTRACT FROM AUTHOR]

Despite a link between adverse childhood experiences (ACEs) and anxiety, the role of anxiety in the pathway to chronic pain is unclear. Potentially, inflammatory biomarkers such as C-reactive protein (CRP) are involved. Objectives were to (1) examine relationships between reported ACEs, anxiety, and chronic pain, and (2) assess associations between ACEs, anxiety, and CRP levels and between CRP and chronic pain. Data from 24,172 adults who participated in the UK Biobank were used to conduct Poisson regressions to assess relationships between ACEs, anxiety, and chronic pain. For participants with CRP data who met the inclusion criteria (n = 2007), similar models were run between ACEs, anxiety, and CRP, and CRP and chronic pain. For objective 1, three statistically significant interactions were found to predict pain: frequency of physical abuse x reported muscular symptoms during anxiety (p = 0.01); frequency in which they felt hated x having discussed anxiety with a professional (p = 0.03), and reported frequency of sexual abuse x difficulties relaxing during anxiety attacks (p = 0.03). For objective 2, frequency of sexual abuse and informing a professional about anxiety significantly interacted to predict elevated CRP. For correlations, the largest was between CRP and the number of times pain was reported over the years (p = 0.01). Finally, ACEs (physical abuse, sexual abuse, and whether taken to a doctor) significantly interacted with CRP to predict pain. This study suggests mechanisms of the impact of ACEs on chronic pain may include inflammation and anxiety, which warrants further study. [ABSTRACT FROM AUTHOR]

Background: Previous research has examined the role of parental religious belief in offspring mental health, but has revealed inconsistent results, and suffered from a number of limitations. The aim of this study is to examine the prospective relationship between maternal religiosity and offspring mental health and psychosocial outcomes. Methods: We used latent classes of religious belief (Highly religious, Moderately religious, Agnostic, Atheist) in mothers from the Avon Longitudinal Study of Parents and Children from 1990, and examined their association with parent-reported mental health outcomes and self-reported psychosocial outcomes in their children at age 7–8 (n = 6079 for mental health outcomes and n = 5235 for psychosocial outcomes). We used inverse probability weighted multivariable logistic regression analysis adjusted for maternal mental health, adverse childhood experience, and socioeconomic variables. Results: There was evidence for a greater risk of internalising problems among the offspring of the Highly religious and Moderately religious classes [e.g. for depression; OR 1.40. 95% CI (1.07–1.85), OR 1.48, 95% CI (1.17–1.87)], and greater risk of externalising problems in the offspring of the Atheist class [e.g. for ADHD; OR 1.41, 95% CI (1.08–1.85)], compared to the offspring of the Agnostic class. Conclusions: These novel findings provide evidence associations between maternal religiosity and offspring mental health differ when examined using a person-centred approach, compared to the previously used variable-centred approaches. Our findings also suggest that differences may exist in the relationship between religious (non)belief and mental health variables when comparing the UK and US. [ABSTRACT FROM AUTHOR]

Background: Experience of childhood adversity is associated with greater anger as an adult, particularly in men. Soldiers and veterans report higher incidence of adverse childhood experiences, many of whom also experience elevated rates of PTSD and anger. However, little is known about factors which may protect against the development of anger after experiencing childhood adversity. Objective: This study aims to assess the potential protective aspects of perceived social support in military veterans. Methods: Data from the Northern Ireland Veterans' Health and Wellbeing Study (N = 590, Mage = 56) was utilised in regression models to examine perceived social support (family, friend, partner; MSPSS) as a moderator of the association between adverse childhood experiences (ACEQ-10) and anger (DAR-7). This sample comprised men who were UK Armed Forces veterans residing in Northern Ireland. Results: Significant interaction effects, visualised using interaction plots, were found between perceived friend support and both child abuse and household challenge. When men perceived high friend support, there was no association between child abuse or household challenge and anger. For veteran men who perceived the maximum amount of partner support, there was no association between child abuse and anger. Family support did not change the positive association between child abuse, child neglect or household challenge and future anger. Conclusions: This study indicates that it is especially important to foster supportive and empathetic friendships for men that have experienced adversity as a child, perhaps through programmes such as Men's Sheds, as these friendships may alleviate the negative influences of child abuse and household challenge on anger. Perceived friend and partner support were protective factors against the development of anger for veterans that experienced child abuse or household challenge. Child neglect had the strongest association with adult anger, unchanged by any type of perceived support. Programmes which foster friendships may be particularly beneficial for veterans transitioning out of the military. [ABSTRACT FROM AUTHOR]

In the UK military, adjustment disorder (AjD) is reported as one of the most diagnosed mental disorders, alongside depression, in personnel presenting to mental health services. Despite this, little is understood about what may predict AjD, common treatment or outcomes for this population. The systematic review aimed to summarise existing research for AjD in Armed Forces (AF) populations, including prevalence and risk factors, and to outline clinical and occupational outcomes. A literature search was conducted in December 2020 to identify research that investigated AjD within an AF population (serving or veteran) following the PRISMA guidelines. Eighty-three studies were included in the review. The AjD prevalence estimates in AF populations with a mental disorder was considerably higher for serving AF personnel (34.9%) compared to veterans (12.8%). Childhood adversities were identified as a risk factor for AjD. AjD was found to increase the risk of suicidal ideation, with one study reporting a risk ratio of 4.70 (95% Confidence Interval: 3.50–6.20). Talking therapies were the most common treatment for AjD, however none reported on treatment effectiveness. This review found that AjD was commonly reported across international AF. Despite heterogeneity in the results, the review identifies several literature gaps. [ABSTRACT FROM AUTHOR]

There is a burgeoning evidence base highlighting the positive influence of benevolent childhood experiences (BCEs), even in the context of adversity. However, few measures are available to assess BCEs. The current study sought to develop and validate a measure which assesses positive recollections of experiences and emotions at home and with family during childhood called the 'Memories of Home and Family Scale'(MHFS). Confirmatory factor analysis (CFA) was employed to test the latent structure of the preliminary MHFS item scores in a sample of university students from the United Kingdom (N = 624). Following selection of the best-fitting model and final items for inclusion in the scale, total and subscale scores were correlated with a range of mental health outcomes. CFA results indicated that the latent structure of the MHFS items was best represented by a correlated six-factor first-order model. The final MHFS demonstrated high levels of internal reliability and convergent validity. [ABSTRACT FROM AUTHOR]

Those who experience parental domestic abuse in childhood are affected in multiple ways, but existing research uses a narrow lens, relying on psychotherapeutic and neuroscientific understandings. This article uses a dialogical theory to explore women's recovery stories. Interviews were conducted with 10 women in England and a voice-centered narrative analysis was used. This article attends to gendered, psychotherapeutic, and neoliberal narrative resources that shaped participants' stories. It concludes that recoveries after domestic abuse in childhood can be considered as dynamic processes that are individual, as well as shaped by social, political, and relational contexts that shape storytelling practices. [ABSTRACT FROM AUTHOR]

Objectives: Cognitive analytic therapy (CAT) is used within UK mental health settings as a treatment for transdiagnostic complex psychological presentations. However, it is not routinely offered by the NHS Talking Therapies, for anxiety and depression (NHS Talking Therapies) programme which provides psychological treatments for common mental health difficulties. We aimed to evaluate the outcomes of providing CAT treatment to patients presenting with depression and/or anxiety, within the context of relational difficulties, adverse childhood experience or difficulty managing emotions, returning for further psychological treatment within NHS Talking Therapies. Methods: This was a pragmatic, real‐world evaluation, involving routinely collected self‐report measures of depression and anxiety, to examine the treatment outcomes of NHS Talking Therapies patients offered CAT over an 18‐month period. Quantitative validated measures of depression and anxiety were administered at the beginning and end of CAT treatment, and at follow up. Within‐group change in depression and anxiety scores were examined statistically, and rates of reliable improvement and recovery calculated. Results: Statistically significant decreases in depression and anxiety scores were observed during the CAT active treatment phase. The recovery rate was 46.4%, and 71.4% of patients showed a reliable improvement post‐treatment. Positive outcomes continued to be observed at follow‐up, with a recovery rate of 50% and a reliable improvement rate of 79.4%. Conclusions: CAT shows promise as a treatment option for NHS Talking Therapies patients re‐presenting with depression and/or anxiety. More research is required to determine if CAT should be offered more widely within NHS Talking Therapies services. [ABSTRACT FROM AUTHOR]

Limited research has been conducted about the prevalence and impact of Adverse Childhood Experiences (ACEs) and mental health difficulties on those with children's services involvement in the UK. Audit data were taken from 111 cognitive and psychological assessment reports in adults aged 18 to 55 within SWIFT specialist family service in Southeast England between May 2019 and April 2021. Descriptive analyses were conducted to show ACE type and prevalence, gender, and mental health (depression and anxiety levels) using self-report and measures such as the Generalised Anxiety Disorder questionnaire (GAD-7), Patient Health Questionnaire (PHQ-9), and Hospital Anxiety and Depression Scale (HADS). Our cohort displayed higher levels of difficulties than the general population, i.e. experiencing multiple ACEs (53.2 per cent). The female participants in our cohort expressed a higher number of ACEs and reported greater symptoms levels of depression than males. Ensuring the provision of trauma-informed therapeutic intervention may aid these individuals with making and sustaining meaningful change and escaping the intergenerational trauma cycle. Future research exploring causation and identifying potential therapeutic provisions with this population is necessary. [ABSTRACT FROM AUTHOR]

Bondage/discipline, dominance/submission, and sadism/masochism (BDSM; "kink") are frequently pathologized as derivatives of abuse. Although the link is unsubstantiated, some kink-identified people who happen to be survivors of trauma may engage in kink, or trauma play, to heal from, cope with, and transform childhood abuse or adolescent maltreatment. The present study sought a thematic model (Braun & Clarke, Qualitative Research in Psychology, 3(2), 77–101, 2006) of trauma recovery through kink using a critical realist, inductive approach to inquiry. Participants were eligible if they had experienced early abuse, were adults, and practiced kink. Six superordinate themes were generated from semi-structured interviews with 20 participants from five countries: cultural context of healing (e.g. using BDSM norms and previous therapy to reframe kink and trauma), restructuring the self-concept (e.g. strengthening internal characteristics which had been harmed or distorted), liberation through relationship (e.g. learning to be valued by intimate others), reclaiming power (e.g. setting and maintaining personal boundaries), repurposing behaviors (e.g. engaging in aspects of prolonged exposure), and redefining pain (e.g. transcending painful memories through masochism). Notably, participants only reported retraumatizing experiences prior to learning about the structural safeguards of BDSM. Research and clinical implications are discussed by drawing on general models of trauma recovery. [ABSTRACT FROM AUTHOR]

Background: Adverse childhood experiences during key developmental periods have been shown to impact long-term health outcomes. Adverse childhood experiences may include psychological, physical, or sexual abuse; neglect; or socioeconomic factors. Adverse childhood experiences are linked with an increase in poor health behavior such as smoking and alcohol consumption, and may also influence epigenetic changes, inflammatory response, metabolic changes, and allostatic load. Objective: We sought to explore associations between adverse childhood experiences and allostatic load in adult female participants in the UK Biobank. Design: The UK Biobank is a multisite cohort study established to capture lifestyle, environment, exposure, health history, and genotype data on individuals in the United Kingdom. Methods: Adverse childhood experiences were assessed from the Childhood Trauma Screener, which measures abuse and neglect across five items. Biological measures at enrollment were used to construct allostatic load, including measures of metabolic, inflammatory, and cardiovascular function. Females with a cancer diagnosis prior to enrollment were removed as it may influence allostatic load. Poisson regression models were used to assess the association between adverse childhood experiences and allostatic load, accounting for a priori confounders. Results: A total of 33,466 females with complete data were analyzed, with a median age at enrollment of 54 (range = 40–70) years. Among the study sample, the mean allostatic load ranged from 1.85 in those who reported no adverse childhood experiences to 2.45 in those with all adverse childhood experiences reported. In multivariable analysis, there was a 4% increase in average allostatic load among females for every additional adverse childhood experience reported (incidence rate ratio = 1.04, 95% confidence interval = 1.03–1.05). Similar results were observed when assessing individual adverse childhood experience components. Conclusion: This analysis supports a growing body of evidence suggesting that increased exposure to early life abuse or neglect is associated with increased allostatic load in females. [ABSTRACT FROM AUTHOR]

Why you should read this article: • To increase your awareness of the psychological benefits of massage therapy • To read about barriers and facilitators to introducing seated chair massage in forensic mental health settings • To consider the value of introducing seated chair massage in your own clinical setting Massage therapy has recognised psychological benefits, yet it is rarely used in forensic mental health settings. In 2022, ten-minute sessions of seated chair massage – where recipients remain fully clothed – were offered to patients and staff at a secure forensic mental health and learning disability service in the UK. This article is a service evaluation of the impact of providing these sessions. Seated chair massage was found to have overwhelmingly positive effects in the short term and the authors concluded that it is a low-risk, boundaried and appropriate complementary therapy intervention for patients in forensic mental health settings. Their findings challenge the view that these settings are essentially 'no touch' environments. The article outlines barriers and facilitators to introducing seated chair massage in a forensic mental health service, which may be useful to other teams considering developing a similar service. [ABSTRACT FROM AUTHOR]

Adverse childhood experiences (ACEs) commonly co-occur, and researchers often estimate their impact using a cumulative risk approach. The person-centered approach offers another approach to operationalize the co-occurrence of ACEs. This study aims to estimate latent classes of ACEs in a sample of U.K. children, examine their relationship with emotional and behavioral problems, and compare the explanatory value of the latent classes to cumulative risk scores. Data were collected among a general population sample of British 10-year-old children extracted from the U.K. Household Longitudinal Study (N = 601). Seven items characterized ACEs, comprising parent-report physical discipline, emotional abuse, supervisory neglect, maternal psychological distress, child-report parental educational disinterest, bullying victimization, and adverse neighborhood. Outcome measures were derived from the self-report Strengths and Difficulties Questionnaire including total difficulties, emotional symptoms, conduct problems, hyperactivity, peer problems, and prosocial behavior. Latent class analysis resulted in a three-class solution: low ACEs, household challenges, and community challenges. Compared to the other classes, the community challenges class scored substantially worse on total difficulties, emotional symptoms, and peer subscales. The cumulative risk score was associated with all outcomes except prosocial behavior. Cumulative risk models accounted for a larger proportion of variance compared with the latent class models, except for peer problems which the person-centered model explained better. This study confirms that ACEs are associated with impairment in child functioning, and that both person-centered and cumulative risk approaches can capture this relationship well. Specifically, the person-centered approach demonstrated how co-occurring risk factors in the community challenges class produced particularly poor internalizing outcomes. [ABSTRACT FROM AUTHOR]

In 2021, during a drug-related death crisis in the UK, the Government published its ten-year drugs strategy. This article, written in collaboration with the Faculty of Public Health and the Association of Directors of Public Health, assesses whether this Strategy is evidence-based and consistent with international calls to promote public health approaches to drugs, which put 'people, health and human rights at the centre'. Elements of the Strategy are welcome, including the promise of significant funding for drug treatment services, the effects of which will depend on how it is utilized by services and local commissioners and whether it is sustained. However, unevidenced and harmful measures to deter drug use by means of punishment continue to be promoted, which will have deleterious impacts on people who use drugs. An effective public health approach to drugs should tackle population-level risk factors, which may predispose to harmful patterns of drug use, including adverse childhood experiences and socioeconomic deprivation, and institute evidence-based measures to mitigate drug-related harm. This would likely be more effective, and just, than the continuation of policies rooted in enforcement. A more dramatic re-orientation of UK drug policy than that offered by the Strategy is overdue. [ABSTRACT FROM AUTHOR]

Aims: Childhood trauma has been associated with adult psychosocial outcomes linked to social exclusion. However, the strength of these associations in the general population is unknown. The emergence of the UK Biobank, with rich phenotypic characterization of the adult population, affords the exploration of the childhood determinants of adult psychopathology with greater statistical power. The current study aims to explore (1) the associations between childhood trauma and social exclusion in adulthood and (2) the role that self‐reported loneliness and symptoms of distress play in the associations. Methods: This study was an analysis of 87,545 participants (mean [± SD] age = 55.68 [7.78], 55.0% female, 97.4% White) enrolled in the UK Biobank. Childhood trauma was determined by the five‐item Childhood Trauma Screener. Current loneliness and symptoms of anxiety (Generalized Anxiety Disorder Scale‐7) and depression (Patient Health Questionnaire‐9) were also entered in analyses. Outcomes were "limited social participation," "area deprivation," "individual deprivation," and "social exclusion" from a previously determined dimensional measure of social exclusion in the UK Biobank. Results: Hierarchical multiple regression models indicated small associations between childhood trauma and social exclusion outcomes, explaining between 1.5% and 5.0% of the variance. Associations weakened but remained significant when loneliness, anxiety, and depression were entered in the models; however, anxiety symptoms demonstrated a negative association with "individual deprivation" and "social exclusion" in the final models. Depression was most strongly associated with "individual deprivation," "area deprivation," and "social exclusion" followed by childhood trauma. Loneliness was most strongly associated with "limited social participation." Conclusions: Experiences of childhood trauma can increase the propensity for adulthood social exclusion. Loneliness and symptoms of depression attenuate but do not eliminate these associations. Anxiety symptoms have a potentially protective effect on the development of "individual deprivation." Findings add to the growing body of literature advocating for trauma‐informed approaches in a variety of settings to help ameliorate the effects of childhood trauma on adult psychosocial outcomes. Further research, however, is required. [ABSTRACT FROM AUTHOR]

Women are often underrepresented or entirely missing from veteran research, and there remains limited understanding of their mental health needs. The present study investigated the mental health needs of a community sample of UK women veterans. A total of 750/1680 (44.6%) participants completed an online survey. Data was collected on sociodemographic and military factors, mental health and wellbeing, and childhood adversity. Findings revealed a high prevalence and comorbidity of mental health difficulties, including common mental health difficulties (28.6%) and posttraumatic stress disorder (PTSD) (10.8%). Women veterans who were older, not working, held a lower rank during service, perceived less social support and experienced greater loneliness were more likely to report such difficulties. Results further revealed high childhood and military adversity, and wellbeing difficulties. Such findings provide insight into the needs of women veterans and have implications for providing appropriate support. Considerations of the generalizability of findings are discussed. [ABSTRACT FROM AUTHOR]

The author contemplates her personal experiences with Hackney's social services, professionals and their treatment of children in foster care and care leavers as they transitioned to adulthood. She describes her negative experience while under the care of the service from 2005 to 2012. She points out how social services had failed children in care due to their negligence and failings within the system. She relates the positive treatment she received from leaving care service social workers.

The question of why people become terrorists has preoccupied scholars and policy makers for decades. Yet, very little is known about how lay people perceive individuals at risk of becoming terrorists. In two studies conducted in the U.K., we aimed to fill this gap. Study 1 showed that Muslims and non-Muslims perceived a potential minority-group terrorist in terms of both structural (e.g., life-history, social) and individual risk factors (e.g., personality, psychopathology, ideology). In Study 2, Muslims and non-Muslims perceived a potential right-wing majority-group terrorist as having more individual predispositions to terrorism than a potential left-wing majority-group terrorist. Importantly, in both studies, individualist perceptions such as psychopathology were positively associated with support for stricter law enforcement, whereas structuralist perceptions such as adverse childhood experiences were positively associated with support for social interventions. Lay people seem to have multifactorial understandings of individuals at risk of becoming terrorists, which influence their counterterrorism policy support. [ABSTRACT FROM AUTHOR]

Background: Children who have adverse childhood experiences (ACEs) tend to have more physical and mental health problems when they are adults compared with people who do not have ACEs. Evidence suggests that partial or no immunisation status can be associated with factors (including ACEs) that make children at higher risk of poor outcomes than immunised children. Aim: To explore the idea that ‘missed immunisations’ could be used as a proxy indicator in identifying children at risk of worse outcomes. Design & setting: Service improvement study in seven GP practices in south London, UK. Method: Children aged 0–3 years who were ≥3 months late for immunisations were identified; their computer notes were reviewed during interdisciplinary meetings between health visitors (HVs) and GP practice staff. A bespoke template was used to guide discussions and to record action plans. Evaluation methods included a survey of practitioners and anonymised questionnaires about care management for a sample of children. Results: Issues of concern, including some ACEs (for example, domestic abuse, mental health concerns in parent), were identified in 57% of children. Ninety-four per cent of practitioners found multidisciplinary meetings useful; 62% of practitioners changed the way they thought about providing care to very young children and their families. Of the children discussed during multidisciplinary meetings, 38% subsequently caught up on immunisations. Conclusion: ‘Late for immunisations’ appears to be a useful indicator for proactively identifying children with issues that make them at risk of poorer outcomes. Integrated working between GPs and HVs is important for ensuring targeted care is provided to families. [ABSTRACT FROM AUTHOR]

Background Little is known on whether associations between childhood autistic traits and psychotic experiences persist into adulthood and whether genetic confounding and childhood trauma influence them. Here we investigate the associations between childhood autistic traits and psychotic experiences until young adulthood and assess the influence of schizophrenia polygenic risk and childhood traumatic experiences, using the Avon Longitudinal Study of Parents and Children (ALSPAC) population-based birth cohort. Study design We used a measure of broad autistic traits (autism factor mean score), and four dichotomised measures of autistic traits capturing social communication difficulties (age 7), repetitive behaviours (age 5), sociability (age 3), and pragmatic language (age 9). Psychotic experiences were assessed at ages 18 and 24 using the semi-structured Psychosis-Like Symptoms interview (PLIKSi). Traumatic experiences between ages 5 and 11 were assessed with questionnaires and interviews administered to children and parents at multiple ages. Study results Broad autistic traits, as well as social communication difficulties, were associated with psychotic experiences that were distressing and/or frequent until age 24 (autism factor mean score, n = 3707: OR 1.19, 95%CI 1.01–1.39; social communication difficulties, n = 3384: OR 1.54, 95%CI 0.97–2.45). Childhood trauma mediated a substantial proportion of the identified associations (~28% and 36% respectively, maximum n = 3577). Schizophrenia polygenic risk did not appear to confound the associations. Multiple imputation analyses (maximum n = 13 105) yielded comparable results. Conclusions Childhood trauma may be an important, potentially modifiable pathway between autistic features and later onset of psychotic psychopathology. [ABSTRACT FROM AUTHOR]

Suicide is a leading cause of death worldwide, with childhood maltreatment identified as a significant risk factor for suicidal behavior in adulthood. The link between childhood maltreatment and suicidality is well-documented; however, the role of complex posttraumatic stress disorder (CPTSD), which includes an additional symptom cluster of disturbances in self-organization (DSO) compared to posttraumatic stress disorder (PTSD), remains underexplored. This study aimed to investigate the association between meeting the criteria for ICD-11 PTSD or CPTSD and suicidality in adults with a history of childhood maltreatment across culturally diverse samples. Data were collected across four sites: the United States, the United Kingdom, China, and Malaysia. The Childhood Trauma Questionnaire (CTQ), Suicidal Behaviors Questionnaire-Revised (SBQ-R), and International Trauma Questionnaire (ITQ) were used to assess childhood maltreatment, suicidality, and PTSD or CPTSD, respectively. Linear regressions were conducted to examine the associations, controlling for demographic variables (age, sex, ethnicity, educational level, and subjective socioeconomic status) as well as the severity of maltreatment (CTQ total scores). Among the 1324 participants who experienced childhood maltreatment, meeting the criteria for CPTSD was significantly associated with higher suicidality compared to not meeting the criteria for either PTSD or CPTSD (B(SE) = 1.68 (0.30), p <.001), or only meeting the criteria for PTSD (B(SE) = 1.38 (0.43), p <.001). In contrast, meeting the criteria for PTSD alone was not significantly associated with suicidality (B(SE) = 0.35 (0.46), p =.45). These associations remained consistent across different cultural settings. The study findings highlight the unique association of CPTSD with suicidality in adults with a history of childhood maltreatment, suggesting that the DSO symptom cluster of CPTSD, which distinguish it from PTSD, play a critical role in the development of suicidality in this population. Targeting these symptoms may be essential for effective intervention strategies. Screening for childhood maltreatment and CPTSD in individuals at risk of suicide is crucial for guiding treatment planning. • CPTSD is linked to suicidality in adults exposed to childhood maltreatment. • PTSD alone is not linked to suicidality in this population. • These associations hold true across various cultural contexts. • DSO symptoms in CPTSD may be key drivers of suicidality in this group. • Targeting DSO could be key for effective treatments in this at-risk group. [ABSTRACT FROM AUTHOR]

Background: Though links between childhood maltreatment and mental health have been established, little known about how specific types of childhood maltreatment tend to cluster and how the resulting patterns of exposure impact mental health outcomes. Method: The current study used latent profile analyses in Chinese (N = 544) and UK (N = 589) samples to identify childhood psychological maltreatment profiles (i.e., profiles of psychological abuse, psychological neglect, and psychological non-support) in different country contexts, and their associations with a range of mental health (i.e., depression, anxiety, anger, physical aggression, verbal aggression, and hostility), and broader well-being (i.e., self-esteem) outcomes. Unadjusted as well as analyses adjusted for adverse childhood experiences (ACEs) were conducted. Results: Four profiles were identified in both samples, but their nature differed between the Chinese sample ("Psychological Non-support", "Low-Maltreated", "High-Maltreated", and "Severe-Maltreated") and the UK sample ("Low-Maltreated", "Moderate-Maltreated", "High-Maltreated", and "Severe-Maltreated"). Individuals in the "Psychological Non-support" in China and "Low-Maltreated" class in the UK displayed better mental health outcomes–lower levels of depression, anxiety, and aggression, and higher self-esteem. In contrast, individuals in the "Severe-Maltreated" profiles in both the Chinese and UK samples displayed poorer mental health outcomes–higher depression, anxiety, and aggression, and lower self-esteem. Interventions and prevention efforts are needed for individuals categorized in profiles affected by psychological maltreatment. Conclusion: This study highlights the importance of using targeted intervention or prevention to prevent psychological maltreatment, as well as improve mental health outcomes in individuals who have experienced psychological maltreatment. [ABSTRACT FROM AUTHOR]

Introduction. Childhood trauma and adversity are common across societies and have strong associations with physical and psychiatric morbidity throughout the life-course. One possible mechanism through which childhood trauma may predispose individuals to poor psychiatric outcomes is via associations with brain structure. This study aimed to elucidate the associations between childhood trauma and brain structure across two large, independent community cohorts. Methods. The two samples comprised (i) a subsample of Generation Scotland (n=1,024); and (ii) individuals from UK Biobank (n=27,202). This comprised n=28,226 for mega-analysis. MRI scans were processed using Free Surfer, providing cortical, subcortical, and global brain metrics. Regression models were used to determine associations between childhood trauma measures and brain metrics and psychiatric phenotypes. Results. Childhood trauma associated with lifetime depression across cohorts (OR 1.06 GS, 1.23 UKB), and related to early onset and recurrent course within both samples. There was evidence for associations between childhood trauma and structural brain metrics. This included reduced global brain volume, and reduced cortical surface area with highest effects in the frontal (β=-0.0385, SE=0.0048, p(FDR)=5.43x10-15) and parietal lobes (β=-0.0387, SE=0.005, p(FDR)=1.56x10-14). At a regional level the ventral diencephalon (VDc) displayed significant associations with childhood trauma measures across both cohorts and at mega-analysis (β=-0.0232, SE=0.0039, p(FDR)=2.91x10-8). There were also associations with reduced hippocampus, thalamus, and nucleus accumbens volumes. Discussion. Associations between childhood trauma and reduced global and regional brain volumes were found, across two independent UK cohorts, and at mega-analysis. This provides robust evidence for a lasting effect of childhood adversity on brain structure. [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]

Background Adverse childhood experiences (ACEs) are traumatic events in childhood that can have impacts throughout life. It has been suggested that ACEs should be 'screened' for, or routinely enquired about, in childhood or adulthood. The aim of this work is to review evidence for this against the United Kingdom National Screening Committee (UKNSC) programme criteria. Methods A rapid review of evidence on ACEs screening was conducted using the approach of the UKNSC. Results Good quality evidence was identified from meta-analyses for associations between ACEs and a wide range of adverse outcomes. There was no consistent evidence on the most suitable screening tool, setting of administration, and time or frequency of use. Routine enquiry among adults was feasible and acceptable to service users and professionals in various settings. A wide range of potentially effective interventions was identified. Limited evidence was available on the potential for screening or routine enquiry to reduce morbidity and mortality or possible harms of screening. Conclusions Based on the application of available evidence to UKNSC screening criteria, there is currently insufficient evidence to recommend the implementation of a screening programme for ACEs. Further research is needed to determine whether routine enquiry can improve morbidity, mortality, health and wellbeing. [ABSTRACT FROM AUTHOR]

Background: Few studies have integrated the impact of individual and cumulative childhood maltreatment on multiple psychiatric symptoms, with the mechanisms underlying these associations largely unknown. This study aims to comprehensively assess the associations between childhood maltreatment, multiple peripheral immune biomarkers, and various psychiatric symptoms in adulthood and to explore whether peripheral immune inflammation plays a mediator role in the associations between childhood maltreatment and psychiatric symptoms in adulthood., Methods: Using data from the UK Biobank, we constructed a retrospective cohort study of 138,915 participants who provided self-reported childhood maltreatment and had peripheral immune biomarkers assessed. We examined seven types of psychiatric symptoms in adulthood, including depressive symptoms, anxiety symptoms, mania, post-traumatic stress disorder (PTSD), psychotic experiences, self-harm, and alcohol use disorder. Logistic regression models were performed to explore the associations between childhood maltreatment, immune biomarkers, and psychiatric symptoms, calculating the average marginal effects for each indicator of childhood maltreatment. Mediation analyses were conducted to determine the extent to which the immune biomarkers could explain the association between childhood maltreatment and psychiatric symptoms in adulthood. Subgroup and sensitivity analyses were also performed., Results: Among the participants, 77,937 (56.10 %) were female, with a mean age of 55.91 (SD: 7.73) years at baseline. There were dose-response relationships existed between the accumulation of childhood maltreatment indicators and all seven assessed psychiatric symptoms and multimorbidity in adulthood (e.g., for depressive symptoms, OR = 1.67 [95 %CI, 1.57 to 1.78] for one childhood maltreatment indicator; OR = 2.77 [95 % CI, 2.58 to 2.97] for two; OR = 4.91 [95 % CI, 4.61 to 5.24] for three or more). Emotional abuse and physical neglect showed the strongest average marginal effects on psychiatric symptoms. Levels of C-reactive protein (CRP) and counts of leukocytes and neutrophils were positively associated with depressive symptoms (e.g., OR = 1.13 [95 % CI, 1.08 to 1.17] for CRP level), anxiety symptoms, PTSD, and psychotic experiences. Moreover, levels of CRP partially mediated the association between childhood maltreatment scores and psychiatric symptoms, albeit with a relatively low mediation proportion (0.65 %-1.77 %)., Conclusions: Our findings underscore the importance of interventions that address multiple forms of childhood maltreatment to mitigate long-term mental health challenges substantially. While peripheral immunity responses may serve as predictors of mental health problems, they might not to be the primary mechanism through which childhood maltreatment influences psychiatric symptoms in adulthood., (Copyright © 2024 Elsevier Inc. All rights reserved.)

Background: Psychosis rates are higher among some migrant groups. We hypothesized that psychosis in migrants is associated with cumulative social disadvantage during different phases of migration. Methods: We used data from the EUropean Network of National Schizophrenia Networks studying Gene-Environment Interactions (EU-GEI) case–control study. We defined a set of three indicators of social disadvantage for each phase: pre-migration, migration and post-migration. We examined whether social disadvantage in the pre- and post-migration phases, migration adversities, and mismatch between achievements and expectations differed between first-generation migrants with first-episode psychosis and healthy first-generation migrants, and tested whether this accounted for differences in odds of psychosis in multivariable logistic regression models. Results: In total, 249 cases and 219 controls were assessed. Pre-migration (OR 1.61, 95% CI 1.06–2.44, p = 0.027) and post-migration social disadvantages (OR 1.89, 95% CI 1.02–3.51, p = 0.044), along with expectations/achievements mismatch (OR 1.14, 95% CI 1.03–1.26, p = 0.014) were all significantly associated with psychosis. Migration adversities (OR 1.18, 95% CI 0.672–2.06, p = 0.568) were not significantly related to the outcome. Finally, we found a dose–response effect between the number of adversities across all phases and odds of psychosis (⩾6: OR 14.09, 95% CI 2.06–96.47, p = 0.007). Conclusions: The cumulative effect of social disadvantages before, during and after migration was associated with increased odds of psychosis in migrants, independently of ethnicity or length of stay in the country of arrival. Public health initiatives that address the social disadvantages that many migrants face during the whole migration process and post-migration psychological support may reduce the excess of psychosis in migrants. [ABSTRACT FROM AUTHOR]

OBJECTIVES: Adverse childhood experiences (ACEs) are prevalent in the population and yield several adverse consequences for child health and development as they accumulate. The objective of the current study is to examine the association between ACEs and adolescent police contact using a national, longitudinal study of adolescents born in the United Kingdom. METHODS: Data come from a sample of 11 313 adolescents who participated in the UK Millennium Cohort Study (MCS), which is a national, longitudinal study of adolescents born in the United Kingdom between 2000 and 2002. Accumulating ACEs were measured at ages 5 and 7 years and reports of police contact were measured at age 14 years, including being stopped and questioned, warned/cautioned, and arrested. RESULTS: Accumulating ACEs at ages 5 and 7 years are associated with a significant increase in the odds of experiencing police stops by age 14 years, with 3 or more ACEs corresponding to a 100% increase in the odds of police stops. Additional analyses reveal that behavioral health factors at age 11 years explain 58.5% to 78.1% of the association between ACEs and adolescent police stops, with externalizing behavior explaining the largest portion of the association. Finally, accumulating ACEs were most relevant to being warned/cautioned or arrested by police. CONCLUSIONS: A history of accumulating ACEs during early childhood elevates the likelihood of police contact by age 14 years, in part by undermining behavioral health. Findings highlight the potential for early interventions in the lives of ACE-exposed adolescents to curtail justice system involvement. [ABSTRACT FROM AUTHOR]