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

Female offenders released from prison often face challenges within the community such as lack of employment, inconsistent attendance in substance use treatment, and complying with parole and probation conditions, which typically decreases their self-efficacy and motivation to refrain from reoffending. Despite this, much is still unknown of psychological factors that could impact female offenders' attitudes toward self-efficacy, such as mental illness symptoms, Adverse Childhood Experiences (ACEs), and personality differences. Thus, this cross-sectional study explored whether mental illness symptoms, ACEs, and personality differences were associated with attitudes toward self-efficacy (N = 398). Results suggest that mental illness symptoms, ACEs, and neuroticism negatively associated with attitudes toward self-efficacy in contrast to extraversion and conscientiousness. Parole/probation reentry and therapeutic implications are discussed. [ABSTRACT FROM AUTHOR]

The assessment of physical and mental health is an integral part of the process of choosing substitute carers for children and young people. It must be done during adoption, foster care or kinship and special guardian assessments. Medical Advisers for adoption and fostering from a paediatric or general practice background are ideally placed to undertake this review of the GP-completed Adult Health report. Having the knowledge and experience to write evidence-based advice for social workers undertaking the assessment of the substitute carers is paramount. While medical advisers are able to review health conditions in substitute carers which may impact on their ability to care and be emotionally available, they are also able to hold the possible short and long-term needs of a vulnerable and possibly damaged child at the centre of the process. The complexity of children for whom substitute carers are sought has increased and carers need to be resilient, emotionally available and healthy enough to care for and nurture a child until adulthood which can be at 18 years, or beyond if there are additional needs. [ABSTRACT FROM AUTHOR]

Summary Background Objectives Methods Results Conclusions Early life socioeconomic disadvantage and adverse experiences may lead to overeating, which is in turn associated with increased body mass index (BMI). However, recent evidence indicated that the association between childhood BMI and overeating might be bidirectional. This bidirectionality prompts the need for further investigation of early life predictors of BMI in childhood.To longitudinally assess the directionality of the association between childhood BMI and perceived overeating and to investigate their antecedent early life predictors.The sample included data from 5151 children from the ELSPAC study, collected between 18 months and 11 years of child age. The outcomes were child BMI and mother‐reported overeating, assessed at the age of 3, 5, 7 and 11 years. Predictors included maternal BMI, maternal education, single parenthood, financial difficulties and adverse childhood experiences (ACEs) reported by parents and paediatricians. The random intercept cross‐lagged panel model was applied.The mean child's BMI at age 3 was 15.59 kg/m2 and increased to 17.86 kg/m2 at age 11. The percentage of parent‐reported overeating increased in the following period, from about 12% at age 3 to 17% at age 11. The results showed temporal stability in perceived overeating and BMI, with a bidirectional relationship strengthening over time. The child's BMI was associated with maternal BMI. Maternal BMI was positively associated with child‐perceived overeating, but a stronger effect was found for ACEs. ACEs mediated the impact of maternal education, financial difficulties and single parenthood on overeating.We observed stable bidirectional associations between BMI and perceived overeating. The results indicated two main pathways: one linked to maternal BMI and early childhood BMI increase followed by perceived overeating and the second associated with ACEs mediating the effect of early childhood social factors on perceived overeating, leading to gradual BMI gain. [ABSTRACT FROM AUTHOR]

In this study, we examined predictors of traditional‐aged undergraduate students' (n = 115) lifetime cannabis use during COVID‐19. Participants who had lower scores of self‐regulation, higher levels of emotional dysregulation strategies, and a higher number of ACEs had more lifetime cannabis use. Additionally, participants' methods of cannabis use changed during the pandemic as they primarily ingested more cannabis products (i.e., edibles) compared with before the pandemic began. Finally, the number of participants using cannabis in group settings during the pandemic was lower compared with before the pandemic began. Implications for counselors and counselor education programs are provided. [ABSTRACT FROM AUTHOR]

The objective of this constructivist grounded theory study was to understand the experiences of students who have been disciplinarily excluded from school. Fifteen students (male, n = 11; Black, n = 10; having special education needs, n = 9) and 16 multidisciplinary staff in Ontario participated. Students experienced high rates of expanded adversities, including school and community violence, systemic racism and inequity. The importance of connection wove throughout the data; however, three themes were found to block connection: unacknowledged impact of adversity, a climate of fear, and the disproportionate impact of limited resources. Trauma-informed culturally attuned approaches that focus on the disproportionate impact of adversity and school discipline at the point of a disciplinary response, and throughout a student's educational experience, are essential. [ABSTRACT FROM AUTHOR]

Conflict-related forced displacement, characterized by the experiences of witnessing violent acts, bombing, torture, separation, and the execution of family members, can severely and negatively impact a child's social determinants of health (SDOH). These experiences are both direct and indirect forms of adverse childhood experiences (ACEs), and urgent attention is needed to understand the impact of forced displacement on children, who are a vulnerable group, and to develop interventions for all systems that influence the child. This phenomenological qualitative study involved in-depth interviews based on the experiences of returnees (n = 20), who are parents of children who experienced forced displacement. This study underscores the direct and indirect impacts of forced displacement on children, with two key themes identified from the data analysis, by concluding that forced displacement: (i) disrupts the positive SDOH of children, and (ii) children's coping mechanisms are influenced by primary and secondary exposure to trauma. The direct effects are visible through the impact of forced displacement on children's mental health as a result of exposure to traumatic material. In contrast, the indirect effects of forced displacement on children are influenced by its subsequential effect on their parents and their community. The study also illuminates systemic inequalities, with participants recommending steps that governmental and non-governmental bodies can take to address this phenomenon. [ABSTRACT FROM AUTHOR]

Contextual risk factors, such as adverse childhood experiences (ACEs), have a significant impact on the mental health of Black youth. Surprisingly, few studies focus efforts specifically on Black youth. The present study investigates the influence of ACEs on psychological distress among Black youth. Additionally, guided by social cognitive theory, this study highlights emotional self-control as a protective mechanism against the negative consequences of ACEs. Our findings show that ACEs (T1) predicted psychological distress among Black youth a year later (T2). Emotional self-control emerged as a significant buffer of ACEs on the association with psychological distress. Thus, to prevent negative mental health outcomes for Black youth, it is imperative to focus prevention efforts on the crucial risk factors that affect healthy development. By working to increase emotional self-control among Black youth who suffered adverse childhood experiences, negative mental health outcomes over time can be reduced. [ABSTRACT FROM AUTHOR]

Although childhood experiences are widely recognized for their potential impact on adult health and happiness, clinical practices apt to solicit and process such experiences with adult clients are often not described in sufficient detail to offer meaningful guidance. The present paper describes how to use the Important Childhood Events (ICE) scale to anchor psychotherapeutic work with parents of extremely high-risk youth in intensive home-based treatment, where childhood experiences may ultimately provide a salient port of entry into identifying and addressing parents' perceptions of their own children's difficulties. We aim to contribute to trauma-informed and mentalization-based clinical practices, particularly for clinicians who are working with families affected by complex, intergenerational trauma in the context of social marginalization. We do this by operationalizing steps in the therapeutic process to prepare both parent and clinician for such difficult conversations, and by describing clinical vignettes which illustrate interventions to foster mentalizing and repair in response to avoidance or dysregulation. [ABSTRACT FROM AUTHOR]

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

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

Trauma-informed care (TIC) benefits to service users and providers are increasingly acknowledged across various health and social care settings. TIC can potentially increase service user engagement, prolong shelter placements, and lessen staff vicarious trauma and burnout. However, studies documenting staff experiences and/or the implementation of TIC are scarce. This limitation has prompted calls for more grounded and applied research into trauma-informed practice, tracking implementation in practice, staff perceptions, barriers, and organisational change. This study aims to address this gap and is an ecological, mixed-methods evaluation of the efficacy of TIC training in a female-only homeless shelter. Quantitative data included 132 incident reports during the first yearly quarters pre- and post-training, hypothesising post-training reductions in incident numbers and severity. Using expansive thematic analysis, semi-structured interviews with six shelter staff (n = 6) explored employee views of TIC relative to trauma understanding, incident management, and integration in practice. Findings revealed a marginal increase in incident numbers and a statistically significant reduction in incident severity post-TIC with a 50% reduction in calls to emergency medical services (EMS). Participant accounts of working practice pre- and post-TIC uncovered increased trauma understanding, increased confidence and competence, healing relationships, and enhanced self-care. Findings are discussed with reference to Substance Abuse and Mental Health Services Administration (SAMHSA)’s (2014) trauma-informed framework and Yatchmenoff et al’s. (2017) core questions in evaluating TIC. While these results are significant as one of the first evaluations of TIC training in Ireland, limitations and implications for future research and practice are considered.

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

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

A systematic literature review and meta‐analysis was performed to evaluate the effects of dapagliflozin on low‐density lipoprotein (LDL) cholesterol in type 2 diabetes mellitus. Data on changes in LDL cholesterol, adverse cardiac events (ACEs), glycated hemoglobin (HbA1c), and fasting blood glucose (FBG) were pooled in a meta‐analysis. Data from dose comparison trials were separately pooled, and meta‐analysis was conducted by using RevMan (5.4.1) and R (4.1.2). Dapagliflozin increased LDL cholesterol by 2.33 mg/dL (95% CI, 1.46 to 3.19; I2 = 0%; P < .00001), increased risk of ACEs by 1.56 (95% CI, 1.02 to 2.39; I2 = 0%; P < .04), decreased HbA1c by −0.41% (95% CI, −0.44 to −0.39; I2 = 85%; P < .00001), and decreased FBG by −13.51 mg/dL (95% CI, −14.43 to −12.59; I2 = 92%; P < .00001) versus any placebo or active comparator. Dapagliflozin 10 mg monotherapy increased LDL cholesterol by 1.71 mg/dL (95% CI, −1.20 to 4.62; I2 = 53%; P = .25) versus a 5 mg dose and by 1.04 mg/dL (95% CI, −1.17 to 3.26; I2 = 62%; P = .36) versus a 2.5 mg dose. Dapagliflozin 10 mg monotherapy increased LDL cholesterol by 3.13 mg/dL (95% CI, 1.31 to 4.95; I2 = 0%; P = .0008), increased the risk of ACEs by 1.26 (95% CI, 0.56 to 2.87; I2 = 0%; P = .58), decreased HbA1c by −0.4% (95% CI, −0.45 to −0.35; I2 = 89%; P < .00001), and decreased FBG by −8.39 mg/dL (95% CI, −10 to −6.77; I2 = 96%; P < .00001) versus a placebo or active comparator. Dapagliflozin monotherapy resulted in a minimal but statistically significantly (P = .0002) increase in LDL cholesterol. However, this minor change does not increase the risk of ACEs (P = .17) when compared with placebo or active comparator. [ABSTRACT FROM AUTHOR]

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

This study validated a scale to explore family dynamics on a continuum of problematic to positive parenting practices that are believed to relate to college student distress and well-being. A two-factor scale was revealed using Confirmatory Factor Analysis with each factor demonstrating good internal reliability and convergent validity with another validated scale. The new scale better predicted college student mental health and well-being when considered with the frequently used Adverse Childhood Experience Scale (ACES). [ABSTRACT FROM AUTHOR]

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

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

Unhoused children and adolescents have high rates of adverse childhood experiences (ACEs). The objective of this study was to characterize a large cohort of unhoused children and investigate rates of psychiatric diagnoses, medical diagnoses, and utilization of emergency department (ED) resources depending on the presence of additional documented ACEs. A retrospective cohort of all unhoused children who presented to the ED of a large Midwestern health system from January 2014 to July 2019 were included. Unhoused status was determined by address field or ICD-10 code for homelessness (Z59.0). Demographics and ED visits were extracted from the electronic health record. Past medical history, ACEs, chief complaint (CC), length of stay (LOS), imaging, and labs were extracted by chart review. T-tests, chi square tests, and Fisher's exact tests were completed for each sub-analysis. Unhoused children with at least one additional ACE had higher odds of the following psychiatric disorders: depression (OR = 5.2, 95% CI = 3.4- 7.9), anxiety (OR = 3.4, 95% CI = 32.1–5.5), behavioral disorder (OR = 7.2, 95% CI = 35.1- 10.4), psychoses (OR = 6.0, 1.9–18.4), bipolar disorder (OR = 19.8, 95% CI = 34.6–84.9), suicidal ideation (OR = 8.0, 95% CI = 34.8–13.4), post-traumatic stress disorder (OR = 10.1, 95% CI = 35.4–18.6), and attention deficit hyperactive disorder (OR = 4.1, 3.0–5.7). Patients with additional documented ACEs were also more likely to have a prior psychiatric admission (p < 0.001). Unhoused children and adolescents with exposure to additional documented ACEs are more likely to have some serious psychiatric and medical diagnoses compared to other unhoused children. [ABSTRACT FROM AUTHOR]

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

The long-lasting influence of childhood adversity on mental health is well documented; however empirical research examining how this association extends into older adults is limited. This study operationalises adversity using cumulative risk and latent class analysis (LCA) models to assess how adversity exposure and typologies may predict anxiety and depression in older adults. Data came from the Personality and Total Health (PATH) Through Life Project (N = 2551, age 60–66). Participants retrospectively reported their childhood experiences of domestic adversity on a 17-item scale. Mental health was measured using four validated questionnaires of depression and anxiety. Linear and generalised additive models (GAM) indicated a dose-response relationship, where a greater number of cumulative adversities were associated with poorer scores on all four mental health measures. LCA identified a four-class solution; with high adversity and high parental dysfunction being associated with poorer mental health outcomes while moderate parental dysfunction and low adversity groups scored at healthy levels. Women reported higher overall anxiety than men, but no notable interactions between ACEs and gender were observed. Patterns revealed by LCA were similar to patterns shown by the cumulative risk model. There is a large time gap from childhood to assessment, making our study susceptible to recall bias. Also, our findings were based on cross-sectional data, limiting causal inferences. Childhood adversity had independent and additive contributions to depression and anxiety in older adulthood, and both cumulative risk and person-centred approaches captured this relationship. • Cumulative childhood adversity is linked to anxiety and depression in older adults. • Latent ACE classes were differentially associated with anxiety and depression; but largely explained by cumulative risk. • Evidence suggests a long-term influence of childhood adversity on mental health that stretches into older adulthood. • Assessment of childhood adversity may be useful when screening for mental illness. [ABSTRACT FROM AUTHOR]

Adverse Childhood Experiences (ACEs) confer considerable risk for negative outcomes across the lifespan, but there is limited research examining whether the measurement of ACEs can be interpreted the same way across diverse groups of individuals. In particular, the measurement of ACEs among early child education teachers has received little attention. Given that millions of children receive care from early child education teachers, and evidence that ACEs can severely disrupt teacher's abilities to support young children, it is critical to accurately assess for and respond to teacher ACEs. The present study examined the factor structure and measurement invariance of the 11-item Behavioral Risk Factor Surveillance Survey (BRFSS) version of the ACEs measure across a diverse group of teachers. Data were collected from 605 teachers in a southeastern state between 2018 and 2021. Teachers ranged in age from 18 to 81 years (35% young; 56% middle; and 9% older adults) and were diverse across race (46% White; 53% Black). Teachers completed the BRFSS version of the ACEs measure and a demographics questionnaire. Factor analyses replicated the theorized three-factor solution, with household dysfunction, emotional/psychological abuse, and sexual abuse emerging as distinct factors. Multigroup confirmatory factor analyses demonstrated measurement invariance across teacher age and race. Comparisons of scores indicated ACEs levels varied across teacher age and race. Overall, findings suggest the BRFSS version of the ACEs measure can be used to assess adverse childhood experiences across diverse groups of early child education teachers. [ABSTRACT FROM AUTHOR]

BACKGROUND: Research examining the connections between individual adverse childhood experiences (ACEs) and how groupings of interrelated adversities are linked with subsequent health is scarce, limiting our understanding of risk during a period of rapid expansion of ACE screening in clinical practice. The study objective was to conduct a psychometric analysis to derive latent domains of ACEs and related life events and assess the association between each domain and health outcome. METHODS: Participants (3 months-11 years) were recruited from the University of California San Francisco Benioffs Children Hospital Oakland Primary Care Clinic. Children were screened with the Pediatric ACEs and Related Life Events Screener (PEARLS) (n = 340), which assessed 17 total ACEs and related life events, including forms of abuse, household challenges, and social risks. Domains were constructed using confirmatory factor analysis and associations between the three identified domains and 14 health outcomes were assessed using multivariable linear and logistic regression models. RESULTS: Three PEARLS domains were identified: Maltreatment (ω = 0.73, ɑ=0.87), Household Challenges (ω = 0.70, ɑ=0.82), and Social Context (ω = 0.55, ɑ=0.70). Measurement invariance was supported across both gender and screening format. All domains were associated with poorer general and behavioral health and stomachaches. Maltreatment and Social Context were additionally associated with eczema while only Social Context was associated with increased odds of reporting headaches and somatic symptoms. CONCLUSION: In an underserved, urban west-coast pediatric population, the PEARLS found three adversity domains of Maltreatment, Household Challenges, and Social Context that all had an independent statistically significant association with poorer child health. The results provide a timely and more nuanced representation of risk that can inform clinical practice and policy using more targeted resources and interventions.

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

Objectives: Adverse childhood experiences (ACEs) are associated with frailty, while the association with frailty state transitions and the role of social participation remain unclear. This study aimed to investigate the association between ACEs and frailty state transitions, alongside the moderating effect of social participation Methods: Data from 9,621 adults aged 45 and older from the China Health and Retirement Longitudinal Study (2011–2020) were analyzed. Frailty was measured with the frailty index, while ACEs and social participation were measured with a validated questionnaire. The association between ACEs and frailty state transitions was estimated using multi-state models. An interaction analysis were used to examine the moderating effects of social participation. Results: Participants with higher ACEs scores (≥4) were associated with an increased probability of forward transition (robust to pre-frail, HR = 1.37, 95%CI: 1.21–1.54; prefrail to frail, HR = 1.39, 95%CI: 1.18–1.63) and decreased probability of backward transition (pre-frail to robust, HR = 0.64, 95%CI: 0.55–0.76). Additionally, participants with moderate and high level social participation were associated with an increased probability of backward transition (pre-frail to robust, HR = 1.11, 95%CI: 1.01–1.23; frail to pre-frail, HR = 1.17, 95%CI: 1.02–1.33, respectively). Social participation moderated the association between ACEs exposure and frailty (P for interaction

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

UNLABELLED: This study introduced the novel concept of Centeredness, a measure of the emotional atmosphere of the family of origin and a target adult individuals perception of feeling safe, accepted, and supported from childhood primary caregivers and other family members. This study developed a Centeredness scale for adult respondents and tested hypotheses that higher levels of overall Centeredness would predict lower levels of depression and anxiety symptoms; suicidal thoughts and behaviors (STBs); and aggressive behavior; and higher levels of life satisfaction. Predictive effects of Centeredness were compared against attachment-related anxiety and avoidance, and adverse and benevolent childhood experiences (ACEs and BCEs). Participants were recruited via the Prolific-Academic (Pro-A) survey panel into two large independent samples of US young adults aged 19-35 years [Sample 1 (test sample), N = 548, 53.5% female, 2.2% gender non-conforming, 68.3% White, recruited before the pandemic; Sample 2 (replication sample), N = 1,198, 56.2% female, 2.3% gender non-conforming, 66.4% White; recruited during the pandemic]. Participants completed the novel Centeredness scale, which showed strong psychometric properties, and standardized, publicly available assessments of childhood experiences and mental health outcomes. Centeredness was the only variable that significantly predicted each mental health outcome across both samples. BCEs predicted all outcomes except aggressive behavior in the test sample. Centeredness and BCEs were also the only two variables that significantly predicted a dimensional mental health composite in both samples. Neither attachment-related anxiety and avoidance nor ACEs were as broadly predictive. The Centeredness scale assesses emotional aspects of childhood family relationships with individuals of diverse backgrounds and family compositions. Clinical and cultural implications are discussed. SUPPLEMENTARY INFORMATION: The online version contains supplementary material available at 10.1007/s42844-023-00089-x.

BackgroundAdverse childhood experiences (ACEs) increase the risk of poor health outcomes later in life. Psychosocial stressors may also have intergenerational health effects by which parental ACEs are associated with mental and physical health of children. Epigenetic programming may be one mechanism linking parental ACEs to child health. This study aimed to investigate epigenome-wide associations of maternal preconception ACEs with DNA methylation patterns of children. In the Center for the Health Assessment of Mothers and Children of Salinas study, cord blood DNA methylation was measured using the Illumina HumanMethylation450 BeadChip. Preconception ACEs, which occurred during the mothers' childhoods, were collected using a standard ACE questionnaire including 10 ACE indicators. Maternal ACE exposures were defined in this study as (1) the total number of ACEs; (2) the total number of ACEs categorized as 0, 1-3, and > 4; and (3) individual ACEs. Associations of ACE exposures with differential methylated positions, regions, and CpG modules determined using weighted gene co-expression network analysis were evaluated adjusting for covariates.ResultsData on maternal ACEs and cord blood DNA methylation were available for 196 mother/newborn pairs. One differential methylated position was associated with maternal experience of emotional abuse (cg05486260/FAM135B gene; q value

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

Introduction: In psychotherapy, it is important to establish and deepen a therapeutic trusting relationship, but patients who have experienced extreme adversity in childhood tend to have difficulty in building such a relationship. This paper reports a case of fibromyalgia with adverse childhood experiences (ACEs) in which a nonverbal approach was successful in building a trusting relationship. Case and methods: The patient is a woman in her late 40s. She had strong anger rooted in ACEs, including neglect by her father, a feeling of unfair parenting by her mother compared to her younger brother, overcontrol of her life by her mother, and sexual abuse by her uncle. She was filled with strong interpersonal distrust and anger, and the experience of an unsuccessful surgery compounded her distrust of medical care. The therapist initially had severe difficulty in verbal interaction with the patient. When conducting "drawing" therapy, she ignored the therapist's comments and completely blacked out the drawing paper. However, the patient-therapist relationship gradually changed, and verbal interaction became possible through the use of nonverbal approaches such as framing her drawing paper and "Towel Baby Holding." Results: The therapist was able to understand the patient's emotions through these nonverbal approaches and to communicate with the patient that she understood her feelings. This approach was also successful in the patient's understanding of her own pathology. The patient became able to honestly express her feelings in words, which eventually enabled her to be introduced to mindfulness therapy, leading to a favorable treatment course. Conclusion: For patients with ACEs, a nonverbal approach helps build a therapeutic relationship and plays an important role in understanding the patient. [ABSTRACT FROM AUTHOR]

Background: Research has shown that Adverse Childhood Experiences (ACEs) are prevalent and are associated with psychological distress. Some studies indicate facing these adversities can lead to post-traumatic growth. This study aims to assess the impact of ACEs on psychological distress and post-traumatic growth and to determine the mediating effect of post-traumatic growth between ACEs and psychological distress, in a sample of adults. Methods: In this study, there were 521 participants (mean = 31.32, SD = 12.28), who answered the following surveys online: a sociodemographic questionnaire, the Family ACE Questionnaire, the Kessler Psychological Distress Scale (K10) and the Post-Traumatic Growth Inventory (PTGI). Results: ACEs were positive and significant predictors of psychological distress, and the "Change in the perception of the self and life in general" factor of post-traumatic growth was the strongest predictor of lower perceived psychological distress. Post-traumatic growth did not mediate the relationship between ACEs and psychological distress. Conclusions: These findings contribute to the improvement of clinical practice and health policies and highlight the need for a more in-depth understanding of the impact of ACEs on mental health. [ABSTRACT FROM AUTHOR]

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

This 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]

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

Parents often face a considerable amount of stress around managing their children's relationships. One source of stress can include instances of physical and emotional sibling violence (PESV). While this form of family violence has received minimal attention compared to other types of family violence, there is a need to better understand parental witnessing of PESV and how it is associated with parents' childhood experiences of PESV as well as adverse childhood experiences. This research study examines the association of parents' childhood experiences of PESV and adverse childhood experiences with witnessing PESV in their children while controlling for current family context variables and childhood family context variables. In a sample of 146 parents recruited from Qualtrics' research panels, parental witnessing of PESV between their children was correlated with both parental experiences of PESV in childhood and adverse childhood experiences. In the regression models, only parental experiences of PESV in childhood, abusive adverse childhood events, and having less education than a bachelor's degree were associated with parental witnessing of PESV between their children when controlling for other variables. The results of the research indicate a potential intergenerational transmission of PESV. Implications of the research support the need for practitioners and those working with parents and families to assess for PESV and educate on this form of family violence to help parents intervene when physical and emotional sibling violence occurs. [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]

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

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

There is a growing body of research documenting the impact of traumatic stress on child development, which has resulted in a call to action for trauma-informed practices as a priority, yet implementation within schools and training for educators is lacking (American Academy of Physicians, https://www.aap.org/en-us/Documents/ttb%5faces%5fconsequences.pdf, 2014). Understanding teachers' perceptions regarding current levels of knowledge, self-efficacy, and trauma-informed training can help guide future professional development experiences for both pre-service and practising teachers. This study investigated the knowledge, self-efficacy, and training of trauma-informed practices as self-reported by primary educators, serving in grades kindergarten through third-grade, within two regions of Tennessee and Virginia. The Primary Early Childhood Educators Trauma-Informed Care Survey for Knowledge, Confidence, and Relationship Building (PECE-TICKCR) scale was adapted from the TIC-DS scale (Goodwin-Glick in Impact of trauma-informed care professional development of school personnel perceptions of knowledge, disposition, and behaviours towards traumatised students, Graduate College of Bowling Green State University, 2017), validated, and created for the purpose of this study. The sample consisted of 218 primary educators who completed an online survey regarding personal knowledge, self-efficacy, and training experiences of trauma-informed practices. Correlations revealed a statistical significance between the Knowledge of Trauma factor and the Confidence in Providing Trauma-Informed Strategies factor. There was also a statistical significance between the Knowledge of Trauma factor and the Confidence in Creating Supportive relationships factor and between the Confidence in Providing Trauma-Informed Strategies factor and the Confidence in Creating Supportive Relationships factor. The findings indicated that teachers need more knowledge regarding community resources for families and students but feel confident in providing supportive relationships. Teachers also are interested in more training events related to strategies to use when working with students exposed to trauma. Implications for teacher preparation programs and professional development training for practising teachers is discussed. [ABSTRACT FROM AUTHOR]