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Background: Individuals with major depressive disorder (MDD) exhibit cognitive impairment, while childhood trauma (CT) is associated with an elevated risk of both MDD and cognitive dysfunction. The effect of CT on cognitive function in MDD patients and healthy controls (HCs) is unclear., Methods: MDD patients and HCs were enrolled between December 2013 and December 2016. The Childhood Trauma Questionnaire (CTQ) was used to assess CT. Depressive symptoms and cognitive function were assessed at baseline and after 8-week acute-phase treatment with selective serotonin reuptake inhibitors (SSRIs) in MDD patients., Results: A total of 909 people were included in the analysis. The interaction between MDD and CT had a main effect on Digit Symbol-Coding Test (DSCT), Stroop Color Test (SCT), and Stroop Color-Word Test (SCWT) scores. The effect of CT on cognitive function disappeared after adjusting for MDD diagnosis and years of education. Neglect could predict poor performance on SCT and SCWT in the HC group. After acute-phase treatment with SSRIs, CT did not significantly predict changes in cognitive function or depressive symptoms., Limitations: The CTQ assessment might cause recall bias, and the cross-sectional design could not establish the causal link between CT and cognitive function., Conclusion: The effect of CT on cognitive function was modulated by MDD diagnosis and years of education. CT did not predict changes in depressive symptoms or cognitive function after acute-phase treatment with SSRIs. The direct influence of CT on cognitive function in MDD patients may be over-estimated., Trial Registration: ClinicalTrials.gov: NCT02023567; registration date: December 2013., Competing Interests: Declaration of competing interest The authors declare that they have no competing interests., (Copyright © 2024 The Authors. Published by Elsevier B.V. All rights reserved.)

Background: There is increasing interest in screening for adverse childhood experiences in pediatric primary care, but no evidence of the actual consequences on behavioral/mental health services. This study tested the association between initiation of ACEs screening in pediatric primary care and changes in the rate of referrals to social work and visits to social work and behavioral health., Methods: Data came from the electronic health records of children and adolescents between 2 and 18 years old who were members of a large integrated healthcare system serving Southern California (N = 513,812). Poisson regression was used to compare the rate of referrals and visits to social work and behavioral health visits for clinics doing standardized ACEs screening (i.e., intervention clinics; n = 28) versus clinics not screening (i.e., control clinics; n = 64) during June 1-December 31 2022 as well as for these same months in 2020 and 2021., Results: Intervention clinics had an average screening rate of 57% (range 26.8 to 91.9%) and an average positive screen rate of 11% (range 1.6-25.1%). The difference in the adjusted rate from 2021 to 2022 was significantly different between intervention and control clinics for referrals to social work (RR 1.48, 95% CI 1.25, 1.74), but was not statistically different for visits to social work or behavioral health., Conclusions: The findings suggest that ACEs screening does not significantly increase the rates of social work and behavioral health visits, although it did increase referrals to social work. We acknowledge that this may vary based on geographic areas and populations served by different healthcare systems., Competing Interests: Declarations. Ethics approval and consent to participate: The need for ethical approval was waived by the Kaiser Permanente Southern California Institutional Review Board. The evaluation of the ACEs clinical initiative was determined as exempt with a waiver of informed consent. Consent for publication: Not applicable. Competing interests: The authors declare no competing interests., (© 2025. The Author(s).)

Background: Dissecting the exposome linked to mental health outcomes can help identify potentially modifiable targets to improve mental well-being. However, the multiplicity of exposures and the complexity of mental health phenotypes pose a challenge that requires data-driven approaches., Methods: Guided by our previous systematic approach, we conducted hypothesis-free exposome-wide analyses to identify factors associated with 7 psychiatric diagnostic domains and 19 symptom dimensions in 157,298 participants from the UK Biobank Mental Health Survey. After quality control, 294 environmental, lifestyle, behavioral, and economic variables were included. An Exposome-Wide Association Study was conducted per outcome in two equally split datasets. Variables associated with each outcome were then tested in a multivariable model., Results: Across all diagnostic domains and symptom dimensions, the top three exposures were childhood adversities and traumatic events. Cannabis use was associated with common psychiatric disorders (depressive, anxiety, psychotic, and bipolar manic disorders), with ORs ranging from 1.10 to 1.79 in the multivariable models. Additionally, differential associations were identified between specific outcomes-such as neurodevelopmental disorders, eating disorders, and self-harm behaviors-and exposures, including early life experiences (being adopted), lifestyle (time spent using computers), and dietary habits (vegetarian diet)., Conclusions: This comprehensive mapping of the exposome revealed that several factors, particularly in the domains of those previously well-studied were shared across mental health phenotypes, providing further support for transdiagnostic pathoetiology. Our findings also showed that distinct relations might exist. Continued exposome research through multimodal mechanistic studies guided by the transdiagnostic mental health framework is required to better inform public health policies.

Background: Previous studies identified clusters of first-episode psychosis (FEP) patients based on cognition and premorbid adjustment. This study examined a range of socio-environmental risk factors associated with clusters of FEP, aiming a) to compare clusters of FEP and community controls using the Maudsley Environmental Risk Score for psychosis (ERS), a weighted sum of the following risks: paternal age, childhood adversities, cannabis use, and ethnic minority membership; b) to explore the putative differences in specific environmental risk factors in distinguishing within patient clusters and from controls., Methods: A univariable general linear model (GLS) compared the ERS between 1,263 community controls and clusters derived from 802 FEP patients, namely, low (n = 223) and high-cognitive-functioning (n = 205), intermediate (n = 224) and deteriorating (n = 150), from the EU-GEI study. A multivariable GLS compared clusters and controls by different exposures included in the ERS., Results: The ERS was higher in all clusters compared to controls, mostly in the deteriorating ( β =2.8, 95% CI 2.3 3.4 , η 2 = 0.049) and the low-cognitive-functioning cluster ( β =2.4, 95% CI 1.9 2.8, η 2 = 0.049) and distinguished them from the cluster with high-cognitive-functioning. The deteriorating cluster had higher cannabis exposure (mean difference = 0.48, 95% CI 0.49 0.91) than the intermediate having identical IQ, and more people from an ethnic minority (mean difference = 0.77, 95% CI 0.24 1.29) compared to the high-cognitive-functioning cluster., Conclusions: High exposure to environmental risk factors might result in cognitive impairment and lower-than-expected functioning in individuals at the onset of psychosis. Some patients' trajectories involved risk factors that could be modified by tailored interventions.

Adverse childhood experiences (ACEs) are important life course events that can influence elder abuse victimisation (EAV) among older adults. This systematic review and meta-analysis aimed to provide synthesised and consolidated evidence on the existing associations between ACEs and EAV. A systematic search was conducted across six databases, including PubMed, PsycINFO, CINAHL Complete, Scopus, Google Scholar, and the Web of Science. All studies that addressed associations between ACEs, in singular or multiple form, and EAV were included in the review. Meta-analysis of the extracted odds ratios (ORs) and confidence intervals (CIs) was conducted using the common-effect inverse-variance model. Nine studies (cross-sectional design = 7; cohort design = 2) met the inclusion criteria. Included studies examined multiple ACEs and multiple EAVs associations (N = 3); at least single ACE and multiple EAVs (N = 3); any single form of ACE and multiple EAVs (N = 3); multiple ACEs-any single form of EAV nexus (N = 2); multiple ACEs-financial elder abuse association (N = 2); and multiple ACEs-physical elder abuse nexus (N = 2). Pooled ORs and CIs showed statistically significant results for all ACEs and EAVs associations whether in singular or multiple form. The results indicate that interventions designed to reduce ACEs, in singular or multiple form, early in life targeting residential and community-dwelling older adults may be relevant in reducing the incidence of EAV. The life course perspective s be integrated into the planning for support services for children, families, and older adults to prevent EAV in singular or multiple forms in later life., Competing Interests: The authors have declared that no competing interests exist, (Copyright: © 2025 Awuviry-Newton et al. This is an open access article distributed under the terms of the Creative Commons Attribution License, which permits unrestricted use, distribution, and reproduction in any medium, provided the original author and source are credited.)

Background: Childhood trauma is a pervasive issue contributing to adverse mental health outcomes. Obtaining optimal sleep supports healthy development and protects against mood-related disorders. Whether sleep serves as a potential buffer between trauma and adverse mental health outcomes holds promise for informing targeted interventions and prevention for adolescents., Methods: Data were drawn from the baseline assessment of a randomised controlled trial of a mental health prevention program. A total sample of 752 adolescents completed an online, self-report survey in 2023. Participants were students (M age =13.8 years), attending independent schools in Australia and comprised of 37% girls and 60% boys. Australian sleep guidelines were used to dichotomise nightly sleep duration into whether adolescents met, or did not meet, the sleep guidelines for their age. Mixed-effects linear regression was used to examine whether sleep moderated the association between trauma and symptoms of anxiety, depression, and mental wellbeing., Results: The majority of participants (82%) reported exposure to at least one traumatic event. The mean number of traumatic events was 1.8. Trauma was independently associated with higher depressive and anxiety symptoms and lower mental wellbeing scores. Those reporting exposure to one or more traumatic events were more likely to report difficulties falling asleep and less likely to report meeting nightly sleep duration guidelines. We found a significant interaction between meeting nightly sleep duration guidelines and any trauma exposure on depressive and anxiety scores, such that depression and anxiety symptoms were lower in trauma-exposed adolescents who met sleep duration guidelines compared to those who did not meet sleep guidelines., Conclusions: Obtaining optimal amounts of sleep each night may help mitigate anxiety and depressive symptoms for non-clinical adolescents exposed to trauma, however, longitudinal research is needed to confirm the directionality of the relationships between trauma, sleep, and mental health symptoms. Future research should examine the effectiveness of public health interventions targeting sleep behaviours in adolescents to promote mental wellbeing., Competing Interests: Declarations. Ethics approval and consent to participate: This study was conducted in accordance with the Declaration of Helsinki. Ethical approval was obtained from the University of Sydney Human Research Ethics Committee (HREC 2022/700), the Maitland-Newcastle Catholic School Diocese and Canberra Goulburn Catholic School Diocese. Informed consent to participate was obtained from participants and from parents or legal guardians of any participant under the age of 16. The OurFutures Mental Health study was prospectively registered with the Australian and New Zealand Clinical Trials Registry (ACTRN12622001582741; date registered 22/12/2022). Consent for publication: Not applicable. Competing interests: The authors declare no competing interests., (© 2025. The Author(s).)

Background: Childhood adversity places individuals in a vulnerable position, resulting in potentially enduring disadvantage across life domains like health and work. Studying the manifestation of this disadvantage is crucial for understanding which resources society can provide to mitigate or prevent it, which makes this subject a fundamental public health concern. This study investigated whether disadvantage patterns after childhood adversity differ by gender and educational level, using out-of-home care as proxy for early adversity., Methods: We used register data from a 1953 Swedish birth cohort. Distinct profiles of socioeconomic and health disadvantage in individuals with out-of-home care experience were identified using group-based multi-trajectory modelling. Multinomial logistic regression was then used to determine whether gender and education, individually or in interaction with each other, predict group membership., Results: In the population without history of out-of-home care, adulthood disadvantage was highly gendered, with women being more likely to experience disadvantage related to unemployment and poor health, while criminality and substance misuse was more common among men. History of out-of-home care was associated with a general increase in adulthood disadvantage, but the gender differences were largely absent. Women in this group were however less likely than men to experience disadvantage across multiple life domains (complex disadvantage OR = 0.56, p = 0.046; unemployment-related disadvantage OR = 0.51, p = 0.005). Higher level of education was associated with reduced likelihood of membership in the group marked by disabling health disadvantage (OR = 0.55, p = 0.002) and complex disadvantage (OR = 0.37, p = 0.001). An interaction term between gender and education was not significant., Conclusions: Adulthood disadvantage was more common in the group with history of out-of-home care. The gender differences in disadvantage present in the full cohort were largely attenuated among individuals with out-of-home care history. We showed that using administrative data on outcomes across multiple life domains can provide rich descriptions of adult experiences after childhood adversity. Future research could examine gender differences in mechanisms translating into resilient or vulnerable trajectories, including the protective potential of education in relation to specific disadvantage patterns., Competing Interests: Declarations. Ethics approval and consent to participate: This study was based on anonymised individual-level register data and, therefore, the need for informed consent was deemed unnecessary according to national regulation. All methods were carried out in accordance with relevant guidelines and regulations. Ethical approval of this study was granted by the Swedish Ethical Review Authority (no. 2019–04376). The Regional Ethical Review Board in Stockholm approved the creation of the dataset, SBC Multigen (no. 2017/34 − 31/5; 2017/684 − 32). Consent for publication: Not applicable. Competing interests: The authors declare no competing interests., (© 2025. The Author(s).)

Adverse childhood experiences (ACEs) have diverse effects on physical development and mental health. This study aimed to clarify the relationship between the quantity of ACE exposure, type of ACE exposure, and subjective level of stress felt, correlated with event-related potential activity across the scalp, while controlling for relevant confounding variables. Fifty-three participants aged 18-32 years completed questionnaires assessing their current mental health, self-regulation, childhood socioeconomic status, and history of traumatic events. Electroencephalographic activity was recorded while participants completed the Combined Attention Systems Task, a modified flanker task. Using cluster-corrected robust statistical approaches, significant relationships existed between the total number of ACEs, ACE type, the subjective impact of trauma, and amplitudes during the error-related negativity (ERN) and error positivity (Pe) at various scalp locations. In the ERN time window, greater error-correct differences were associated with greater total ACEs, abuse, and other ACEs at C5, P9, and TP10/C1 clusters, respectively. In addition, reduced error-correct differences at cluster-maximal C2 during the timing of the Pe were related to experiencing greater numbers of total ACEs while increased error-correct differences at cluster-maximal FPz during the timing of the Pe were associated with greater numbers of other ACEs. The subjective impact of total number of ACEs was not associated with error-correct differences, however, the subjective impact of household dysfunction, abuse, and 'other' ACE types were linked to error-correct differences at various scalp locations and timings. Notably, increased, rather than decreased, subjective impact of household dysfunction was related to greater error-correct differentiation during the timing of the ERN, maximal at Cz. These results suggest that both ACE type and subjective rating are relevant to future outcomes. The effects extended beyond the ERN-affecting error-related positivity and later event-related potentials-indicating associations with the number, type, and subjective impact of ACEs across a larger time window and scalp topography., (© 2025 John Wiley & Sons Ltd.)

Background: Research has demonstrated positive associations between adverse childhood experiences (ACEs) and substance use behaviours in young adults. However, many of these are based on cross-sectional data. The pathway between ACEs and substance misuse among emerging adults is also not fully understood and few studies have investigated potential mediating factors., Methods: We analysed data from the Child Cohort of the Growing Up in Ireland study, a nationally representative longitudinal sample of children recruited at 9 years of age (n = 4,729). Logistic regression was used to examine individual and cumulative ACE exposure relationships with substance use at age 20 years. Mediation analyses were used to assess whether parental and peer relationships and school engagement mediate ACE history associations with substance use behaviours., Results: ACE exposure relationships with current cannabis use, other illicit drug use and problematic drug use were observed. In particular, young adults who had experienced 2 ACEs or 3 + ACEs had an approximate two-fold (OR=1.80, 95 % CI: 1.29, 2.51) and approximate three-fold (OR=2.94, 95 % CI: 2.06, 4.19) increased odds of problematic drug use, respectively, when compared to participants who had experienced no ACEs during the study period. Mediation analyses suggested that parent and peer attachment and liking school partially mediate relationships between ACEs and substance use behaviours., Conclusions: Children who have experienced ACEs are at higher risk of future substance use and problematic drug use. In supporting these children, identified mediators such as interpersonal relationships and school engagement may help guide selection of prevention interventions., Competing Interests: Declaration of competing interest The authors declare that they have no known competing financial interests or personal relationships that could have appeared to influence the work reported in this paper., (Copyright © 2024 The Author(s). Published by Elsevier Ltd.. All rights reserved.)

Background: Emerging evidence suggests that DNA methylation is crucial in the mental disorder pathophysiology. The current study attempted to identify the dysregulation of DNA methylation patterns in adolescent patients suffering from depressive episodes (DE) while considering the impact of various subtypes, including psychotic symptoms and a history of childhood trauma., Methods: The study included 67 patients with DE and 30 healthy controls (HCs) subjects. Severe depressive episode (SDE) patients were grouped according to psychotic symptoms, such as SDE with vs. SDE without psychotic symptoms (cases 29 vs. 21). The Childhood Trauma Questionnaire-Short Form helped assess childhood trauma among all patients. Thus, all the patients were divided into adolescent DE experiencing ≥ two trauma types vs. experiencing ≤ one trauma type (cases, 50 vs. 17). Methylome-wide analysis was conducted on peripheral blood to identify methylation differences in CpG sites for three comparisons: DE vs. HCs, SDE patients with vs. without psychotic symptoms, and DE patients having 0-1 type of childhood trauma vs. those having ≥two types of childhood trauma., Results: Adolescent DE patients demonstrated a predominant trend of lower methylation levels than HCs, with 259 hypermethylated and 3956 hypomethylated sites. Differentially hypomethylated sites involve related genes such as FKBP5, BDNF, NR3C1, GABRB3, SHANK1, SLC38A1, SLC6A18, CHRNB1, CTNNA2, CTTNBP2, etc. All these genes could be involved in DE pathogenesis. Significant DNA methylation differences could be observed in SDE subgroups with and without psychotic symptoms (e.g., genes like DTNB, CNTN1, CTNNA2), along with those DE patients having 0-1 type of childhood trauma compared to those with ≥2 types (e.g., VWA3B, SYT10, SDK2, CAMSAP3). Many significant methylated sites were associated with genes involved in brain development, highlighting the potential pathophysiological mechanisms linked with DE and its subtypes, such as psychotic symptoms and childhood trauma., Conclusion: Our findings suggest that differential DNA methylation is associated with the pathophysiology of DE, as well as the presence of psychotic symptoms and a history of childhood trauma. These blood-based methylation patterns may serve as biomarkers for DE and shed light on underlying mechanisms across these subtypes., Competing Interests: Declaration of competing interest All other authors report no financial interests or potential conflicts of interest., (Copyright © 2024 Elsevier B.V. All rights reserved.)

Introduction: Dissociation is associated with clinical severity, increased risk of suicide and self-harm, and disproportionately affects adolescents and young adults. Whilst evidence indicates multiple factors contribute to dissociative experiences, a multi-factorial explanation of increased risk for dissociation has yet to be achieved., Methods: We used multiple regression to investigate the relative influence of five plausible risk factors (childhood trauma, loneliness, marginalisation, socio-economic status, and everyday stress), and machine learning to generate tentative high-risk profiles for 'felt sense of anomaly' dissociation (FSA-dissociation) using cross-sectional online survey data from 2384 UK-based 16- to 25-year-olds., Results: Multiple regression indicated that four risk factors significantly contributed to FSA-dissociation, with relative order of contribution: everyday stress, childhood trauma, loneliness and marginalisation. Exploratory analysis using machine learning suggested dissociation results from a complex interplay between interpersonal, contextual, and intrapersonal pressures: alongside marginalisation and childhood trauma, negative self-concept and depression were important in younger (16-20 years), and anxiety and maladaptive emotion regulation in older (21-25 years) respondents., Conclusions: Validation of these findings could inform clinical assessment, and prevention and outreach efforts, improving the under-recognition of dissociation in mainstream services., (© 2025 The Author(s). Early Intervention in Psychiatry published by John Wiley & Sons Australia, Ltd.)

Background: Suicide is a major cause of death among youth. Childhood trauma (CT) has emerged as a leading environmental risk factor for suicidal ideation (SI). The present study intends to understand the association between CT and SI in a sample of twins, highlighting the relevance of CT per se, regardless of genetic vulnerability., Methods: Data were derived from a general population young twin study, the TwinssCan project (N = 796; mean age = 17.4). Different types of CT (physical, emotional and sexual) were explored with CTQ and SI through SCL-90-R. The discordance within twin-pairs was used to dissect the genetic and CT effects in SI., Results: Total CT and all subdomains were associated with an increased risk for SI. The within-pair differences analysis in monozygotic and dizygotic twins suggested that part of this association is not attributable to genetic predisposition, which points out the relevance of CT itself upon the increase of SI. This result converged with CT subdomain analyses of physical abuse and neglect., Limitations: While within-pair twin analyses control for genetic risk, additional environmental shared and individual characteristics should be controlled for (such as poverty or protective factors). More detailed information on SI would be of great interest to better capture the complexity of this construct., Conclusion: CT appears to be an important environmental risk factor for SI and at least partly independent of Gene-Environment correlation (rGE). This study highlights the importance of including the history of CT in psychiatric evaluations of patients. The burden of the psychosocial environment on SI could be disentangled by further research on environmental risk and protective factors., Competing Interests: Declaration of competing interest The authors declare no conflicts of interest., (Copyright © 2024 The Authors. Published by Elsevier B.V. All rights reserved.)

Background: Childhood adversity is robustly associated with mental ill-health. Yet questions remain about how different ways of conceptualising adversity relate to psychiatric diagnoses and service activity. This research aims to examine associations between typological and cumulative conceptualisations of adversity, and psychiatric diagnosis and service activity., Methods: We analysed risk assessment data from 21,072 young people attending mental health services in South London. These assessments include items relating to maltreatment, parental mental health difficulties, substance misuse, self-harm, and violent behaviour. Using latent class analysis, we identified the following risk typologies: 'Maltreatment and externalising behaviours' (n = 971, 4·6 %), 'Maltreatment but low risk to self and others' (n = 2526, 12·0 %), 'Anti-social behaviour' (n = 2669, 12·7 %), 'Inadequate caregiver supervision and risk to self and others' (n = 907, 4·3 %), 'Risk to self but not to others' (n = 1725, 8·2 %), and 'Mental health needs but low risk to self and others' (n = 12,274, 58·2 %). Two cumulative risk models were created: 1) all risk items 2) Adverse Childhood Experiences-related cumulative risk (ACES-CR). Controlling for gender, ethnicity, age, and deprivation, we examined associations between risk typologies, cumulative risk, and the following outcomes: 1) psychiatric diagnosis 2) face-to-face appointments 3) missed appointments 4) referral to social services., Outcomes: Risk in its various conceptualisations was consistently and robustly associated with conduct disorder. Risk also tended to be associated with more face-to-face appointments, missed appointments, and referral to social services. Associations between individual risk typologies and psychiatric diagnosis and service activity are discussed., Interpretation: Our findings suggest that typological and cumulative approaches to risk and adversity can produce unique insights about diagnostic practices and service activity. This work provides further evidence for the contribution of contextual factors to mental ill-health and further work is required to explore the longer-term trajectories of these young people., Competing Interests: Declaration of competing interest No conflicts to declare., (Crown Copyright © 2025. Published by Elsevier Inc. All rights reserved.)

Introduction: Adverse childhood experiences (ACEs) are preventable, potentially traumatic events that occur in childhood. Alcohol use during pregnancy can result in miscarriage, stillbirth, preterm birth, and a range of lifelong behavioral, intellectual, and physical disabilities in the child. Limited research has examined the relationship between ACEs and alcohol use in pregnancy; available studies might not reflect current trends in this relationship., Methods: Using 2019-2023 Behavioral Risk Factor Surveillance System data from 41 U.S. jurisdictions, the prevalence of self-reported current alcohol use among pregnant persons aged 18-49 years (N = 2371) was estimated by ACEs and selected characteristics. We calculated unadjusted and adjusted prevalence ratios (aPR) for the relationship between ACEs and alcohol use during pregnancy., Results: The prevalence of current alcohol use was 16.2 % (95 % CI = 11.5-20.9) among pregnant persons who reported experiencing four or more ACEs, and 8.6 % (95 % CI = 5.7-11.5) among those who reported no ACEs. When adjusting for sociodemographic characteristics, pregnant persons who reported four or more ACEs were more likely to report current alcohol use compared to those who reported no ACEs (aPR = 1.8, 95 % CI = 1.1-2.9). Individually, pregnant persons who experienced emotional abuse (aPR = 1.9, 95 % CI = 1.3-2.7) and witnessed intimate partner violence (aPR = 1.6, 95 % CI = 1.1-2.4) were more likely to use alcohol during pregnancy compared to pregnant persons who did not report experiencing these ACEs., Conclusions: Higher ACE exposure was associated with alcohol use during pregnancy. Steps can be taken to mitigate their potential harms. Clinical and community-level interventions can address ACEs, which might reduce alcohol use during pregnancy., Competing Interests: Declaration of competing interest The authors declare that they have no known competing financial interests or personal relationships that could have appeared to influence the work reported in this paper., (Published by Elsevier Inc.)

Background: The mental health consequences of exposure to childhood trauma have been little studied among adolescents in low-income and-middle-income countries (LMICs), despite a relatively high burden of trauma in LMIC populations. We investigated associations between trauma and adolescent psychiatric disorders in the 2004 Pelotas Birth Cohort, Brazil., Methods: In the 2004 Pelotas Birth Cohort, current psychiatric diagnoses (anxiety, mood, attention-hyperactivity, and conduct-oppositional disorders) were assessed at age 15 years (caregiver-report Development and Well-being Assessment), and age 18 years (self-report Mini-International Neuropsychiatric Interview). Lifetime cumulative trauma was assessed via caregiver report up to age 11 years and combined self-report and caregiver-report thereafter. Exposure to 12 trauma types were assessed (serious accident, fire, other disaster, attack or threat, physical abuse, sexual abuse, witnessed domestic violence, witnessed attack, witnessed accident, heard about attack, heard about accident, and parental death). Due to the high prevalence of trauma exposure in the sample, the number of different types of trauma exposure reported was extracted as a proxy for cumulative trauma load. We assessed both cross-sectional and longitudinal associations between cumulative trauma load and psychiatric disorders during adolescence using logistic regression, adjusting for confounders and pre-existing child psychopathology at 48 months. We also computed population attributable fractions (PAFs) for trauma-mental health associations at age 18 years., Findings: 4229 adolescents (51·9% male, 48·1% female) were included in logistic regression analyses based on imputed data. Trauma exposure affected 81·2% of adolescents by age 18 years. At age 15 years, the odds of any disorder (adjusted odds ratio [aOR] 1·19 [95% CI 1·03-1·38]), anxiety disorders (1·45 [1·21-1·75]), and conduct-oppositional disorders (1·60 [1·13-2·27]) increased for each category increase in cumulative trauma, but mood and attention-hyperactivity disorders were not related to cumulative trauma. At age 18 years, the odds of any disorder (1·34 [1·24-1·44]), anxiety disorders (1·23 [1·13-1·34]), mood disorders (1·33 [1·22-1·46]), attention-hyperactivity disorders (1·24 [1·09-1·41]), and conduct-oppositional disorders (1·59 [1·36-1·86]) all increased for each category increase in cumulative trauma. In longitudinal analyses, each category increase in cumulative trauma by age 11 years was associated with an increased odds of any disorder (aOR 1·26 [95% CI 1·11-1·44]), anxiety disorders (1·27 [1·04-1·56]), and conduct-oppositional disorders (1·43 [1·04-1·97]) at 15 years; and trauma up to age 15 years was associated with increased odds of any disorder (1·32 [1·21-1·45]), anxiety disorders (1·27 [1·14-1·40]), mood disorders (1·26 [1·12-1·41]), and conduct-oppositional disorders (1·52 [1·24-1·87]) at age 18 years. Trauma up to age 11 years was not predictive of disorders at age 18 years, and there were no longitudinal associations between trauma and attention-hyperactivity disorders. PAF estimates indicated that trauma exposure accounted for 30·6% (95% CI 21·2-38·7) of psychiatric disorders at age 18 years., Interpretation: Increasing exposure to trauma is associated with mental disorders among Brazilian adolescents. Given the high prevalence of trauma in LMIC populations, strategies to reduce exposure, identify those at greatest risk of mental disorders following trauma, and mitigate the consequences are crucial., Funding: Wellcome Trust, WHO, National Support Program for Centers of Excellence, Brazilian National Research Council, Brazilian Ministry of Health, Children's Pastorate, São Paulo Research Foundation, Rio Grande do Sul Research Foundation, L'Oréal-Unesco-ABC Program for Women in Science in Brazil-2020, All for Health Institute, University of Bath, Economic and Social Sciences Research Council., Translation: For the Portuguese translation of the abstract see Supplementary Materials section., Competing Interests: Declaration of interests GF and SLH report funding for a relevant, but unrelated, project from the UK Medical Research Council. SLH also reports funding for a relevant, but unrelated, project from the Economic and Social Research Council, and is a Scientific Committee member for the UK Trauma Council and Child and War Foundation. AD consulted for the Yale Child Study Center and holds the following roles: Academic Secretary of the Faculty of Child & Adolescent Psychiatry, UK Royal College of Psychiatrists; General Secretary, European Society for Child and Adolescent Psychiatry; and Editor-at-large, Journal of the American Academy of Child & Adolescent Psychiatry. All other authors declare no competing interests., (Copyright © 2025 The Author(s). Published by Elsevier Ltd. This is an Open Access article under the CC BY 4.0 license. Published by Elsevier Ltd.. All rights reserved.)

Introduction: High rates of suicidal ideation (SI), suicide attempts (SA), and repetitive nonsuicidal self-injury (NSSI) among some ethnoracially minoritized United States youth populations may be related to adverse childhood experiences (ACEs) with structural roots., Methods: Using the 2013-2019 Minnesota Student Surveys, we assessed associations of student-reported structural ACEs (parental incarceration, housing instability, food insecurity, and foster care involvement) with SI, SA, and repetitive NSSI within the past 12 months using multilevel logistic regression stratified by ethnoracial group (American Indian/Alaskan Native [AIAN], Hmong, other Asian, Black Latino, other Latino, Somali, other Black/African American [AA], Native Hawaiian/Pacific Islander [NHPI], and multiracial), and adjusted for sex, grade, ACEs experienced within one's household, mental health treatment, and perceived safety., Results: Structural ACEs were strongly associated with increasing SI, SA, and NSSI. At ≥2 structural ACEs, repetitive NSSI rates ranged from 7% to 29% (female), 8% to 20% (male); SA rates ranged from 13% to 35% (female), 10% to 22% (male); and SI rates ranged from 31% to 50% (female), 20% to 32% (male). Black Latino, NHPI, AIAN, and Black/AA students most often reported structural ACE exposures., Conclusion: Reducing structural ACEs may reduce SI, SA, and repetitive NSSI among ethnoracially minoritized youth populations. Disaggregating diverse youth groups revealed variations in these outcomes that remain hidden when subpopulations are aggregated., (© 2024 The Authors. Suicide and Life‐Threatening Behavior published by Wiley Periodicals LLC on behalf of American Association of Suicidology.)

Purpose: This study examined whether the relationship between adverse childhood experiences (ACEs) and self-rated health among adults in a nationally representative population is modified by age, sex, or race/ethnicity., Design: Cross-sectional study., Setting: United States., Sample: Data from the 2020 and 2021 Behavioral Risk Factor Surveillance System were obtained from 185 731 (weighted N = 47 862 016) persons 18 years or older., Measures: The ACE cumulative score (range: 0-11) was calculated using 11 questions about childhood emotional abuse, physical abuse, sexual abuse, and household dysfunction before age 18 and classified as 0 (reference), 1, 2, 3, or ≥4. Self-rated health was divided into (excellent/very good/good [reference]) and suboptimal (fair/poor) categories., Analysis: Multivariable-adjusted logistic regression was conducted to test for the interaction with age, sex, and race/ethnicity with ACEs. After adjustment for potential confounders, an increasing number of ACEs had statistically significantly higher odds of suboptimal self-rated health in a graded manner except for 1 ACE (1 ACE: aOR:1.09; 95% CI: 1.00-1.20, 2 ACEs: 1.16; 1.03-1.30, 3 ACEs: 1.17; 1.03-1.32 and ≥4 ACEs: 1.39; 1.26-1.53). There was a significant interaction between ACEs and age. Younger age (18-24 years) had the strongest association for ≥4 ACEs compared to the older age groups. There was no effect modification by sex or race., Conclusion: ACEs should be considered when creating health-promoting interventions to improve health., Competing Interests: Declaration of Conflicting InterestsThe author(s) declared no potential conflicts of interest with respect to the research, authorship, and/or publication of this article.

Childhood maltreatment is associated with wide-ranging psychopathology at all stages of life. In the current study, we investigated whether posttraumatic stress disorder (PTSD) severity mediated the association between childhood maltreatment and internalizing and externalizing disorders among 262 South African trauma-exposed adolescents (aged 12-18 years). Childhood maltreatment and PTSD symptom severity were assessed using the Childhood Trauma Questionnaire and the Child PTSD Checklist, respectively. Psychiatric disorders were assessed utilizing the Kiddie-Schedule for Affective Disorders and Schizophrenia-Present and Lifetime version and were grouped into internalizing or externalizing disorders. Hierarchal logistic regression was used to assess the association of childhood maltreatment subtype with internalizing and externalizing disorders, controlling for age and gender, with PTSD symptom severity added to the final model. We found that sexual abuse was significantly associated with internalizing disorders, although this effect was no longer significant when PTSD was added to the model demonstrating that PTSD mediated the association between sexual abuse and internalizing disorders. Physical abuse, but not PTSD, was associated with externalizing disorders. Physical abuse, emotional neglect, and PTSD were associated with comorbid internalizing and externalizing disorders. These findings have implications for intervention and prevention strategies targeted at trauma-exposed adolescents with a history of childhood maltreatment.

This study aimed to explore key characteristics of the out-of-home care subgroup of a nationally representative Australian sample. To ensure that mental health services are appropriately targeted, it is critical that we understand the differential impacts of childhood experiences for this cohort. Using the Australian Child Maltreatment Study ( N = 8503), we explored patterns of childhood maltreatment and adversity of participants who reported ever being placed in out-of-home care, such as foster care or kinship care. In addition, the prevalence of current and lifetime diagnosis of four mental health disorders were explored. Results showed that the care experienced subgroup reported more types of maltreatment and adverse experiences than the control group. They were also more likely to meet diagnostic threshold for post-traumatic stress disorder, generalised anxiety disorder and major depressive disorder than the control group. These findings can be used to guide mental health practitioners to target interventions more effectively within the out-of-home care cohort., Competing Interests: Declaration of Conflicting InterestsThe author(s) declared no potential conflicts of interest with respect to the research, authorship, and/or publication of this article.

Background: Adverse childhood experiences (ACEs) often affect multiple children within families, yet studies tend to focus on the health outcomes of individual children, underestimating the needs of affected families. We aimed to examine the association between firstborns exposed to ACEs between 1 year before and 2 years after birth (the first 1000 days) and the risks of mental health problems, mental health-related health-care contacts, and all-cause hospital admissions in multiple children from the same mother, compared to firstborns without ACEs., Methods: We derived a population-based birth cohort in England using linked electronic health records for first-time mothers (aged 14-55 years) with their children (born 2002-18). We followed up the cohort from 1 year before birth up to 18 years after birth across the Clinical Practice Research Datalink GOLD and Aurum databases (primary care), Hospital Episode Statistics (secondary care), and the Office of National Statistics (death registrations) between April 1, 2001, and March 31, 2020. We included six different ACE domains, including child maltreatment, intimate partner violence, maternal substance misuse, maternal mental health problems, adverse family environments, and high-risk presentations of child maltreatment, in the records of the mother or the firstborn in the first 1000 days. The primary outcome was the number of children (aged 5-18 years) with recorded mental health problems per mother. We used adjusted and weighted negative binomial regression models to estimate incidence rate ratios., Findings: Of 333 048 firstborns and their mothers, 123 573 (37·1%) had any ACEs between 1 year before and 2 years after birth, and 65 941 (19·8%) of all mothers had at least one child with a mental health problem between ages 5 years and 18 years (median follow-up 11·4 years [IQR 9·2-14·1]). Mothers with firstborns with ACEs had 1·71 (95% CI 1·68-1·73) times as many children in total with mental health problems (mean 29·8 children per 100 mothers, 29·4-30·1) compared with mothers without firstborns with ACEs (mean 17·4 children per 100 mothers, 17·3-17·6), translating into a mean difference of 12·3 (95% CI 11·9-12·7) additional children with mental health problems per 100 mothers. These mothers also had increased incidence rates of children with all-cause emergency admissions and mental health-related contacts. There was no significant difference in the risk of mental health problems between firstborn and later-born children., Interpretation: ACEs in firstborns during the first 1000 days were associated with increased mental health problems and health-care needs in multiple children in the same family. The findings highlight the importance of early identification of vulnerable first-time parents and firstborns and increased policy focus on sustained support beyond the first 1000 days to promote healthier long-term family outcomes. Future evaluations of interventions should include the health outcomes of multiple children within families., Funding: NIHR Policy Research Programme., Competing Interests: Declaration of interests We declare no competing interests., (Copyright © 2025 The Author(s). Published by Elsevier Ltd. This is an Open Access article under the CC BY 4.0 license. Published by Elsevier Ltd.. All rights reserved.)

Background: Accumulating literature has found a close relation between early life adversity (ELA) and anxiety. However, previous studies did not rule out the high co-occurrence of different types of ELA when exploring the association of ELA and anxiety. In the present study, we carried out network analysis based on a cross-sectional sample and longitudinal sample to investigate the relationship between ELA and anxiety symptoms in non-clinical populations over time., Methods: Online advertisement was carried out to recruit participants. The cross-sectional sample included 871 Chinese participants (M age  = 19.11, SD age  = 1.57), and the longitudinal sample involved 440 Chinese participants (M age  = 18.93, SD age  = 0.75). Three dimensions of ELA were assessed. The Threat/Harm dimension was assessed by subscales of physical abuse, emotional abuse, and sexual abuse of Childhood Trauma Questionnaire (CTQ). The Deprivation dimension of ELA was measured by subscales of physical neglect, and emotional neglect of CTQ. The Unpredictability dimension of ELA was evaluated by the Childhood Unpredictability scale. Anxiety symptoms were captured by the Generalized Anxiety Disorder-7 (GAD-7). Regularized partial correlation networks were constructed, and the expected influence (EI) as well as predictability of each node were calculated. Stability within the network was tested and the network comparison test was conducted to examine the difference between the cross-sectional network and the longitudinal network., Results: The cross-sectional network was relatively tight, and nodes within the dimension of ELA clustered together. Childhood unpredictability and emotional abuse revealed stronger associations with anxiety symptoms than other ELAs. Emotional abuse showed the highest EI in the network. These findings were replicated in the longitudinal network. The network comparison test indicated no significant difference between the cross-sectional network and the longitudinal network., Conclusion: Childhood unpredictability and emotional abuse were strong predictors of anxiety symptoms, and the prediction was reliable and persistent. Reduce the experience of childhood emotional abuse can serve as a target to prevent anxiety., Competing Interests: Declaration of competing interest None., (Copyright © 2024 Elsevier Ltd. All rights reserved.)

There is limited evidence on heterogenous co-developmental trajectories of internalizing (INT) and externalizing (EXT) problems from childhood to adolescence and predictors of these joint trajectories. We utilized longitudinal data from Raine Study participants ( n = 2393) to identify these joint trajectories from 5 to 17 years using parallel-process latent class growth analysis and analyze childhood individual and family risk factors predicting these joint trajectories using multinomial logistic regression. Five trajectory classes were identified: Low-problems (Low-INT/Low-EXT, 29%), Moderate Externalizing (Moderate-EXT/Low-INT, 26.5%), Primary Internalizing (Moderate High-INT/Low-EXT, 17.5%), Co-occurring (High-INT/High-EXT, 17%), High Co-occurring (Very High-EXT/High-INT, 10%). Children classified in Co-occurring and High Co-occurring trajectories (27% of the sample) exhibited clinically meaningful co-occurring problem behaviors and experienced more adverse childhood risk-factors than other three trajectories. Compared with Low-problems : parental marital problems, low family income, and absent father predicted Co-occurring and High Co-occurring trajectories; maternal mental health problems commonly predicted Primary Internalizing, Co-occurring , and High Co-occurring trajectories; male sex and parental tobacco-smoking uniquely predicted High Co-occurring membership; other substance smoking uniquely predicted Co-occurring membership; speech difficulty uniquely predicted Primary Internalizing membership; child's temper-tantrums predicted all four trajectories, with increased odds ratios for High Co-occurring (OR = 8.95) and Co-occurring (OR = 6.07). Finding two co-occurring trajectories emphasizes the importance of early childhood interventions addressing comorbidity.

Background: The prevailing exposure to Adverse Childhood Experiences (ACEs) among youth is associated with adolescents' mental health. However, few studies have examined whether receiving help from mental health services affects mental health outcomes among adolescents with ACEs. Therefore, this study examines the moderated effects of mental health services use on the relationship between exposures to ACEs and mental health outcomes among US adolescents., Methods: The sample was restricted to adolescents aged 11-17 using data from the National Health Interview Survey (NHIS) from 2019, 2021, and 2022. Multivariate logistic regressions and descriptive analyses were performed to estimate the moderation effect of mental health services use., Results: Using mental health services buffered the associations between ACEs and severe anxiety and depressive symptoms. Receiving counseling/therapy moderated the impact of ever living with an individual who had severe anxiety (Adjusted Odds Ratio, AOR: 0.58, p < .05) and depressive symptoms (AOR: 0.38, p < .01) among adolescents. Furthermore, counseling/therapy moderated the effect of ever living with an individual with a history of alcohol or drug abuse on severe depressive symptoms (AOR: 0.49, p < .05) and the effect of being a victim or witness of violence on severe anxiety symptoms (AOR: 0.45, p < .01). In addition, taking prescription medication moderated the effect of the experience of incarcerated family members on severe anxiety symptoms (AOR: 0.41, p < .05)., Conclusion: Our findings suggest that policy and practice need to encourage access to mental health care for vulnerable adolescents with ACEs to reduce the detrimental effect of their experiences on their mental health problems., (© 2024 Association for Child and Adolescent Mental Health.)

Objective: Childhood trauma is a significant environmental stressor linked to mood disorder. It can affect not only the individuals directly involved but also the next generation through the intergenerational transmission of trauma. This study aimed to investigate, for the first time, the co-occurrence of childhood trauma in youths with mood disorders and their parents., Methods: We assessed 443 individuals, 100 youths with DSM-5 mood disorders, 100 youths healthy controls (HCs), 92 s' parents and 161 adult HCs. History of childhood trauma was obtained using the Childhood Trauma Questionnaire (CTQ). The distribution patterns of childhood trauma subtypes was estimated through a multivariate model. Intraclass correlations (ICC) were calculated to account for the familial clustering of the sample., Results: We found significantly higher scores for Patients as compared to Young-HC in all the subtypes of childhood trauma (p < 0.05). Considering Parents and Adult-HC groups, Physical abuse (p = 0.001) and Emotional neglect showed higher scores in Parents (p < 0.001). Regarding the familial clustering of the sample, emotional (p < 0.001) and sexual abuse (p = 0.001), and emotional (p = 0.3) and physical neglect (p = 0.003) showed statistical significance, but only emotional abuse reveled a medium level ICC (0.25)., Conclusions: Our study highlights the effect of intergenerational transmission of childhood trauma on the diagnosis of mood disorders in youths. Our findings underscore the significance of systematically assessing childhood trauma, in particular emotional abuse, in youths with mood disorders and their parents. Additionally, there is urgent need for evidence-based preventive measures aimed at promoting positive parenting strategies and emotionally supportive environments for children., Competing Interests: Declaration of competing interest The authors have no financial interests or potential conflicts of interest to declare., (Copyright © 2024 The Authors. Published by Elsevier B.V. All rights reserved.)

Background: Adverse childhood experiences (ACEs) are associated with behavioral health challenges and high school dropout, and behavioral health is associated with high school dropout. Less is known about the role of behavioral health challenges in the relationship between ACEs and high school dropout., Methods: Using data from the Panel Study of Income Dynamics (2013) and its 2014 Childhood Retrospective Circumstances Study supplement, the current study conducts mediational path analysis to examine the direct and indirect effects of cumulative ACEs on high school dropout via adolescent depression, anxiety, and substance use., Results: Experiencing more ACEs was associated with depression, anxiety, and substance use. Only depression and substance use were associated with high school dropout. There was a significant direct effect between increased ACEs and high school dropout and significant indirect effects via depression and substance use, but not anxiety., Conclusions: Adolescent behavioral health interventions to address the long-term effects of ACEs may also support academic achievement. School-based interventions, particularly those aligned with trauma-sensitive school frameworks and engaging various school personnel, including school nurses, should be considered. Community- and policy-level interventions aimed at primary prevention of ACEs are also needed., (© 2024 The Author(s). Journal of School Health published by Wiley Periodicals LLC on behalf of American School Health Association.)

Context: Exposure to adverse childhood experiences (ACEs) is associated with adverse impacts on subsequent generations. The extent to which caregiver ACEs are associated with their child's ACE score is unclear., Objective: To meta-analytically examine the association between caregiver and child ACE score. Potential moderators of this association were explored., Data Sources: Systematic searches were conducted using MEDLINE, Embase, PsycINFO, and CINHAL from 1998, the year the ACEs questionnaire was published, to February 19, 2024., Study Selection: Inclusion criteria were that the ACEs questionnaire was completed for both caregiver and child, an effect size was available, and the study was published in English., Data Extraction: Variables extracted included sample size and magnitude of association between caregiver ACEs and child ACEs, mean caregiver and child age, sex (% female), race and ethnicity, and informant of ACEs., Results: Seventeen samples (4872 caregiver-child dyads) met inclusion criterion. Results revealed a large pooled-effect size between caregiver and child ACEs (r = 0.33; 95% CI, 0.25-0.41; P < .001), such that higher caregiver ACEs score was associated with higher child ACEs score. This association was stronger among studies with younger caregivers and studies that utilized caregiver-report compared with child self-report of ACEs., Limitations: Many studies were conducted in North America with female caregiver samples, limiting generalizability beyond these populations., Conclusions: Caregiver ACEs were strongly associated with child ACEs. Prevention and intervention efforts for caregivers should be trauma informed and focused on bolstering protective factors that may break cycles of intergenerational risk., (Copyright © 2025 by the American Academy of Pediatrics.)

Background: Adverse childhood experiences (ACEs) may increase the risk for adolescent sleep disturbances, though the impact of race, ethnicity, and socioeconomic status (SES) remains unclear., Objective: We sought to determine the direct and moderating impact of race, ethnicity, family SES, and community SES on sleep disturbances across early adolescence for ACE-exposed youth., Participants and Setting: This secondary analysis used longitudinal Adolescent Brain Cognitive Development Study® data (2016-2022) from youth who experienced ≥1 ACE by age 9-10 years., Methods: Clinically significant sleep disturbances were identified from the annual parent-reported Sleep Disturbances Scale for Children. Parents reported youths' race, ethnicity, family SES, and community SES at baseline. Multilevel mixed effects logistic regression modeling examined the impact of race, ethnicity, and SES on sleep disturbances over four years among ACE-exposed youth. Adjusted odds ratios with 95 % confidence intervals are presented (adj. OR [95 % CI])., Results: Among 6661 youth with ACE exposure, 2402 (36.1 %) had clinically significant sleep disturbances at baseline. Multiracial (versus White) youth were 27 % likelier to have clinically significant sleep disturbances over time (adj. OR 1.27 [95 % CI 1.01, 1.59]). Similar results were found for youth exposed to ≥2 family financial adversities (adj. OR 1.50 [95 % CI 1.19, 1.90]). There were no effects of community SES, nor interaction effects of race, ACEs, or SES on sleep disturbances., Conclusion: While Multiracial youth may experience additional stressors which affect sleep disturbances, regularly assessing family environments and supporting all families to meet basic needs may positively impact adolescent sleep., Competing Interests: Declaration of competing interest Senger-Carpenter and Voepel-Lewis received funding from the National Institute of Nursing Research (F31NR020837-01) and National Institute on Drug Abuse (RO1-DA052310). There are no other declarations of interest., (Copyright © 2024 Elsevier Ltd. All rights reserved.)

Background: There is well-established evidence linking adverse childhood experiences (ACEs) and chronic pain in adulthood. It is less clear how ACE exposure might influence the response to chronic pain treatment. In this systematic review, we synthesise the literature assessing the impact of ACE exposure on outcomes relating to the use, benefits, and harms of analgesic medications (analgesia-related outcomes)., Methods: We searched seven databases from inception to September 26, 2023, for studies investigating adverse events in childhood (<18 yr) and any analgesia-related outcome during adulthood (≥18 yr). Title/abstract screening, full-text review, data extraction, and risk of bias assessment were performed independently by two authors. Given the high degree of study heterogeneity, a narrative synthesis was performed., Results: From 7531 records, 66 studies met inclusion criteria, involving 137 395 participants. Analgesia-related outcomes were classed into six categories: use of analgesics (n=12), analgesic side-effects (n=4), substance misuse (n=45), lifetime drug overdose (n=2), endogenous pain signalling (n=4), and other outcomes (n=2). No studies assessed the effect of ACE exposure on the potential benefits of analgesics. ACE exposure was associated with greater use of analgesic medication, higher incidence of analgesic medication side-effects, greater risk and severity of substance misuse, greater risk of drug overdose, and greater risk of attempted suicide in opioid dependency., Conclusions: Adverse childhood experience exposure is associated with poor analgesia-related outcomes, so individual assessment adverse childhood experiences is important when considering the treatment of chronic pain. However, significant gaps in the literature remain, especially relating to the use and harms of non opioid analgesics., Systematic Review Protocol: CRD42023389870 (PROSPERO)., (Copyright © 2024 The Author(s). Published by Elsevier Ltd.. All rights reserved.)

Affluent White rural men have the highest rates of gun ownership in the United States. However, few studies have specifically examined reasons and motivations for gun ownership and gun behaviors in this population. Therefore, this study sought to examine the relationship between stress variables, namely masculine gender role stress, adverse childhood experiences (ACEs), and income level, and subsequent pro-gun beliefs and amount of time an individual carried a gun within this population. Results indicated that only two measures of pro-gun beliefs (i.e., believing guns keep one safe, believing guns are present in one's social sphere) were correlated with percentage of time an individual carried. Additionally, ACEs were positively correlated with believing guns influence how others perceive oneself, levels of masculine gender role stress, and income. These results suggest that White rural gun owners who have increased ACEs have decreased income and tend to believe that owning guns impacts their social status with peers. However, increased ACEs do not influence belief about guns keeping one safe, believing guns are present in one's social sphere, or gun carriage. Instead, White rural gun owners without childhood adversity may be more susceptible to believing their safety depends on guns and belongingness within their social sphere. Future research should assess reasons why affluent White rural men find it important to maintain their safety in the context of gun ownership., Competing Interests: Declaration of conflicting interestsThe author(s) declared no potential conflicts of interest with respect to the research, authorship, and/or publication of this article.

The risk of developing chronic pain is twice as high among people with a history of childhood maltreatment compared to those without these experiences. It is unclear, however, whether childhood maltreatment might lead to lower or higher perception of pain. In this paper, we investigate the association between childhood maltreatment and pain sensitivity. A sample of 187 Dutch adolescents (ages 16.7 to 20.5) was used from a population-based cohort at high-risk for emotional and behavioral problems screened at age 13. The Childhood Trauma Questionnaire short form (CTQ-SF) was completed to measure emotional, physical, sexual abuse, and emotional and physical neglect. To asses pain sensitivity, a thermal quantitative sensory testing procedure was used which measured pain from hot and cold stimuli. Individuals reporting childhood sexual abuse, emotional abuse or neglect and physical neglect could on average withstand hot and cold pain of 1.03 °C [0.13, 1.84] to 3.20 °C [0.62, 5.97] more across different types of abuse compared to those with no emotional abuse or (physical) neglect history. Physical abuse was not associated with pain sensitivity. The current findings suggest that childhood maltreatment might lead to habituation to painful stimuli as opposed to increased pain sensitivity., Competing Interests: Declaration of Competing Interest None., (Copyright © 2024 The Authors. Published by Elsevier Inc. All rights reserved.)

Objective: This study aimed to explore the relationship between adverse childhood experiences (ACEs), sleep, and lower extremity function in older adults using a nationally representative cohort., Methods: This study included 4,439 participants aged 60 years or older (mean age: 67.2 ± 5.7 years) from the China Health and Retirement Longitudinal Study (CHARLS) 2015 national survey and the 2014 Life History Survey. ACEs, sleep duration, and sleep quality were assessed through self-report, and lower extremity function was measured using the Short physical performance battery (SPPB). The relationships between ACEs, sleep, and lower extremity function were analyzed using multivariate linear regression model and restricted cubic splines., Results: After adjusting for covariates, older adults with four or more ACEs exhibited worse lower extremity function compared to those with no ACEs (β: -0.175). 6-8 h of sleep was associated with improved lower extremity function (β: 0.119), while good sleep quality was also associated with higher lower extremity function scores (β: 0.177). Age-related differences revealed that the association between four or more ACEs and reduced lower extremity function (β: -0.431) was significant only in individuals aged 70 years and older. In the 60-69 years age group, the sleep duration of 6-8 h was significantly related to better lower extremity function (β: 0.150), however, in those aged 70 years and older, more than 8 h of sleep was associated with poorer function (β: -0.378). Furthermore, good sleep quality was associated with better lower extremity function in individuals aged 70 years and older (β: 0.246)., Conclusion: ACEs, particularly household mental illness and parental disability, are associated with poorer lower extremity function in older adults. Normal sleep duration and good sleep quality are linked to better lower extremity function and may mitigate the negative effects of ACEs. However, these associations vary by age., Competing Interests: Declarations. Ethics approval and consent to participate: The Ethics Committee of Peking University granted approval for CHARLS (IRB00001052-11015). All participants provided written informed consent. This research followed the guidance of the Declaration of Helsinki. Consent for publication: Not applicable. Competing interests: The authors declare that they have no known competing financial interests or personal relationships that could have appeared to influence the work reported in this paper., (© 2025. The Author(s).)

Objective: Adverse childhood experiences (ACEs) are associated with a range of negative health outcomes, including attention-deficit/hyperactivity disorder (ADHD) and neurocognitive deficits. This study identified symptom profiles in adult patients undergoing neuropsychological evaluations for ADHD and examined the association between these profiles and ACEs., Methods: Utilizing unsupervised machine learning models, the study analyzed data from 208 adult patients., Results: The Gaussian Mixture Model revealed two distinct symptom profiles: "Severely Impaired" and "Moderately Impaired". The "Severely Impaired" profile, 23.6% of the sample, was characterized by more severe ADHD symptomatology in childhood and worse neurocognitive performance. The "Moderately Impaired" profile, 76.4% of the sample, had scores in the average range for self-reported internalizing and externalizing psychopathology and better neurocognitive performance. There was a greater number of ACEs reported by patients in the Severely Impaired profile than the Moderately Impaired profile (p = .022). Specifically, using an ACEs cutoff of ≥4, 53.1% of patients in the Severely Impaired profile reported four or more ACEs, compared with 34.6% in the Moderately Impaired profile (p = .020). Profiles were not related to clinician-ascribed diagnosis., Conclusions: Findings underscore the association between ACEs and worse symptom profiles marked by impaired neurocognitive function, increased internalizing and externalizing psychopathology, and heightened perceived stress in adults with ADHD. Future research may explore the effect of ACEs on symptom profiles in diverse populations and potential moderators or mediators of these associations. Findings offers valuable insights for clinicians in their assessment and treatment planning., (© The Author(s) 2024. Published by Oxford University Press. All rights reserved. For permissions, please e-mail: journals.permissions@oup.com.)

Objective: Adverse childhood experiences (ACE) have inconsistently been implicated as risk factors for immune-mediated inflammatory diseases (IMID). We evaluated whether the association of ACE with disease differs between IMID and other chronic diseases., Design: Nested retrospective case-control study., Setting: We used data from the Canadian Longitudinal Study on Aging (CLSA), which recruited participants aged 45-85 years between 2010 and 2015., Participants: We included 12 627 CLSA participants: 2 102 who reported diagnoses of IMID (258 multiple sclerosis (MS), 1 692 rheumatoid arthritis (RA) and 160 inflammatory bowel disease (IBD)), 5 519 with diabetes, 170 with epilepsy, 3 889 with asthma and 1 125 with no chronic diseases. ACE, including childhood maltreatment (physical, emotional and sexual abuse, neglect) and household dysfunction, were queried using questions from the Childhood Experiences of Violence Questionnaire-Short Form and the National Longitudinal Study of Adolescent to Adult Health Wave III questionnaire., Primary and Secondary Outcome Measures: We first evaluated whether the association of maltreatment differed across diagnoses (IMID, diabetes, asthma, epilepsy, no chronic diseases). Second, we evaluated whether the association between maltreatment differed across IMID. We repeated our analyses for different types of ACE., Results: Maltreatment or household dysfunction was experienced by 64% of participants and 30% experienced both. On multivariable analysis, history of any maltreatment, sexual abuse, any household dysfunction and having ≥3 types of ACE were all associated with increased risk of IMID compared with no chronic disease. The association between ACE and IMID did not differ across MS, RA and IBD., Conclusion: ACE are common among Canadians with and without chronic diseases. History of any maltreatment or household dysfunction is associated with increased risk of chronic disease., Competing Interests: Competing interests: JO’M received research funding from MS Canada and the Consortium of Multiple Sclerosis Centers. CNB is supported by the Bingham Chair in Gastroenterology. CNB has served on advisory Boards for AbbVie Canada, Amgen Canada, Bristol Myers Squibb Canada, Eli Lilly Canada, JAMP Pharmaceuticals, Janssen Canada, Organon Canada, Pendopharm Canada, Sandoz Canada, Takeda Canada and Pfizer Canada; educational grants from AbbVie Canada, Bristol Myers Squibb Canada, Ferring Canada, Organon Canada, Pfizer Canada, Takeda Canada and Janssen Canada; and speaker’s panel for AbbVie Canada, Janssen Canada, Pfizer Canada, and Takeda Canada. CNB received research funding from AbbVie Canada, Amgen Canada Janssen Pharmaceuticals, Pfizer, Sandoz Canada and Takeda Canada. RAM received research funding from: CIHR, MS Canada, Crohn’s and Colitis Canada, National Multiple Sclerosis Society, CMSC, the Arthritis Society, Pfizer Foundation, and the US Department of Defense and is a co-investigator on studies receiving funding from Biogen Idec and Roche Canada., (© Author(s) (or their employer(s)) 2025. Re-use permitted under CC BY-NC. No commercial re-use. See rights and permissions. Published by BMJ Group.)

Background: A significant relationship is present between childhood hunger experiences (CHEs) and health, but explorations of the longitudinal persistence of this relationship and its mediating mechanisms are still lacking. This study aims to evaluate the effects of CHEs on health in middle and old age and determine the underlying mechanisms., Methods: Using data from the five 2011-2020 China Health and Retirement Longitudinal Study (CHARLS) and the 2014 China Life History Survey Questionnaire, a sample of 9,909 individuals aged 45 years and older who participated in all six surveys was obtained. We conducted panel analyses, used Probit and ordinary least squares regression models to analyze the effects of CHEs on the health in middle and old age, and used stepwise regression tests to analyze the mediators of the relationship., Results: CHEs significantly predicted self-assessment of health (β = -0.18; 95% CI: -0.23, -0.12), the probability of receiving medical treatment (β = -0.09; 95% CI: -0.13, -0.05), depression (β = -0.30; 95% CI: -0.35, -0.25), memory (β = -0.13; 95% CI: -0.18, -0.07), and cognitive function (β = -0.13; 95% CI: -0.26, -0.00). The effects of CHEs showed an aggravating trend regarding depression and cognitive function, and a mitigating trend regarding self-assessed health and memory. Smoking, exercising, and sleep duration were revealed as transmitting factors of the effects of CHEs on health., Conclusion: CHEs had a negative impact on the health of middle and old age. While their effects on depression and cognitive function gradually worsen, the effects on self-assessed health and memory were mitigated over time. Lifestyle factors such as smoking, exercising, and sleep duration were transmitting factors of the health effects of CHEs. Thus, the health status of individuals who experience childhood hunger warrants attention., Competing Interests: Declarations. Ethics approval and consent to participate: The ethics review board of Peking University approved the CHARLS study (approval number IRB00001052–11015). Informed consent was obtained, and the data were anonymized for analysis. All methods were carried out in accordance with relevant guidelines and regulations. Consent for publication: Not applicable. Competing interests: The authors declare no competing interests., (© 2025. The Author(s).)

Adverse childhood experiences (ACEs) have been reported to detrimentally impact physical and mental health. While experiencing multiple ACEs is common, previous research primarily assessed ACEs by their total count, neglecting the impacts of different experience types. Furthermore, sex-based differences in ACEs and their influences remain unclear. This study employed Latent Class Analysis (LCA) to uncover patterns of ACEs with consideration for sex differences, aiming to elucidate their effects on adult physical and mental health. A geographically nationally representative dataset from the "Japan COVID-19 and Society Internet Study (JACSIS)" conducted in 2022 was used. 13,715 men and 14,327 women retrospectively reported their experiences across fifteen ACEs. The analysis revealed four distinct ACE patterns for both sexes: a Multiple Adversities class with a wide range of severe ACEs, a Psychological Abuse class experiencing emotional abuse at home and bullying at school, a Poverty class facing economic hardships, and a Low Adversities class with the fewest ACEs. Multinomial logistic regression analysis indicated that more severe patterns of exposure correlated with heightened adverse adult outcomes. However, the extent of these impacts varied by sex and ACE pattern. For instance, men in Multiple Adversities and Psychological Abuse classes exhibited higher tendencies towards conducting physical and psychological abuse behaviors. While ACEs in men were linked to both underweight (in cases of psychological abuse) and obesity (across all classes), women with ACEs generally leaned towards higher body weight. These findings highlight the importance of developing support strategies sensitive to sex differences and the specific content of ACEs., Competing Interests: Declaration of competing interest None., (Copyright © 2024 The Author(s). Published by Elsevier B.V. All rights reserved.)

Background: Mental disorders constitute a global public health problem worldwide and occurs in childhood and lasts to adulthood. The purpose of this study was to explore the association between childhood violence exposure and currently diagnosed depression and anxiety in children and adolescents and investigate whether the association differs by sex and age., Methods: This cross-sectional study used data from 2017 to 2021 National Survey of Children's Health (NSCH). Childhood violence exposure and anxiety or depression of children were reported from caregivers. Logistic regression analyses and subgroup analyses were conducted to assess the association between the childhood violence exposure and anxiety and depression., Results: This study included 113,400 participants aged 6 to 17 years (weighted mean [SD] age, 11.5 [3.4] years; 54,539 females [weighted proportions, 48.9 %]). 9603 of them (weighted proportions, 9.0 %) had childhood violence exposure. Childhood violence exposure was associated with higher risks of anxiety (adjusted risk difference: 7.8 %, 95%CI: 6.3-9.3 %; adjusted OR: 2.11, 95%CI: 1.87-2.39) and depression (adjusted risk difference: 6.2 %, 95%CI: 5.1-7.4 %; adjusted OR: 2.94, 95%CI: 2.54-3.41) after full adjustment. Stratified analyses demonstrated that the association appeared to be stronger in younger children and the association between violence exposure and anxiety was stronger in females than in males., Conclusion: In this cross-sectional study, childhood violence exposure was significantly associated with higher risks of anxiety and depression. The associations appeared to be stronger in younger and female children. Differences in sex and age-specific associations highlight the importance of building age-specific and sex-specific patterns of childhood violence prevention and intervention., Competing Interests: Declaration of competing interest All authors declare no competing interests., (Copyright © 2024 Elsevier B.V. All rights reserved.)

Background: Depression and anxiety are common in the perinatal period. While most of those affected respond well to treatment, a subpopulation is more resistant. Understanding more about individuals who do not respond well to available treatments may improve care for this group., Methods: We administered entry and exit self-report measures to 178 women who participated in a specialized partial hospitalization program for perinatal individuals. Baseline measures of anxiety, obsessive symptoms, sleep quality, early life adversity, and adult attachment security were examined as potential predictors of response to treatment., Results: While no individual baseline survey predicted treatment response, clustering patients on the basis of a combination of self-report adult attachment styles and early life adversity yielded four distinct groups. A cluster with high attachment anxiety, high attachment avoidance, and childhood history of verbal and emotional abuse was less responsive to treatment than the other groups., Conclusions: Combining detailed information about self-report adult attachment style and early life adversity may improve prediction of treatment response in individuals with perinatal mood and anxiety disorders., Competing Interests: Declaration of competing interest TKR and LMO receive research funding from the National Institutes of Child Health and Human Development. LMO receives royalties and editorial fees from American Psychiatric Association Publishing, UpToDate, and Elsevier. CB is medical director and CEO of the Motherhood Center of New York (TMC). All other authors except FB and LMO are employees or paid consultants of TMC in some capacity. Besides the above, the authors have no other financial interests to disclose., (Copyright © 2024 Elsevier B.V. All rights reserved.)

Background: Adverse childhood experiences (ACEs) are traumatic events that occur early in life and can have lasting effects on health and well-being. Previous research has linked ACEs to substance use in adulthood, but there is limited research on the underlying mechanisms or pathways of this relationship. This study explores whether depression mediates the relationship between ACEs and current substance use among U.S. adults., Methods: Data were obtained from the 2021 Behavioral Risk Factor Surveillance System (n = 30,978). Generalized Structural Equation Modeling was used to examine the links between ACEs, cigarette, e-cigarette, and marijuana use while adjusting for sociodemographic characteristics., Results: Approximately 71 % of respondents reported experiencing at least one ACE. The findings show that depressive disorders mediate the relationship between ACEs and current substance use among U.S. adults. There was a significant indirect effect of ACEs on current cigarette use (OR = 1.13, 95 % CI [1.10, 1.16]), e-cigarette use (OR = 1.17, 95 % CI [1.12-1.22]), and marijuana use (OR = 1.22, 95 % CI [1.13, 1.33]) through the mediator of depressive disorders. Additionally, the most pronounced effects were found among those aged 18-24 years for cigarette use (OR = 1.32, 95 % CI [1.11, 1.56]), e-cigarette use (OR = 1.22 [1.09, 1.36]), and especially marijuana use (OR = 1.52 [1.18, 1.96])., Conclusion: These findings suggest that depression may be a key pathway from negative experiences during childhood to certain types of substance use in adulthood, particularly among young adults., Competing Interests: Declaration of competing interest None., (Copyright © 2024 Elsevier B.V. All rights reserved.)

Background: While the impact of adverse childhood experiences (ACEs) on depression is well-documented, how ACEs, physical violence victimization, social support, and school belongingness altogether shape depression from adolescence to young adulthood remains unclear. This study aims to clarify these relations by tracing the trajectory of depression across this critical developmental period., Methods: We utilized a 14-year, four-wave dataset from the National Longitudinal Study of Adolescent to Adult Health (Add Health), including 5734 participants who were 7th to 12th graders at baseline (51.4 % females). Latent growth curve modeling (LGCM) was used to analyze the trajectory of depression from adolescence to young adulthood, assessing the impact of ACEs, physical violence victimization, social support, and school belongingness on this progression., Results: Results from the LGCM indicated that childhood maltreatment and physical violence victimization were positively associated with an increase in depression from adolescence to young adulthood. Conversely, social support and school belongingness showed a negative association with depression, indicating their protective effects over time. Gender was found to moderate these longitudinal associations, with females showing increased vulnerability to the negative relations between early stressful environments (i.e., childhood maltreatment and physical violence victimization) and depression. Conversely, they seemed to benefit more from school belongingness and social support in mitigating depression., Limitations: The study variables were all self-reported and exhibited some issues with reliability., Conclusion: Practitioners should implement gender-specific programs for the prevention and intervention of depression from adolescence through young adulthood., Competing Interests: Declaration of competing interest None., (Copyright © 2024 Elsevier B.V. All rights reserved.)

Background: The associations between adverse childhood experiences (ACEs), childhood socioeconomic status (SES), and depressive symptoms (DS) remain unclear. This study aimed to assess the separate and joint associations of ACEs and childhood SES with DS and explore the potential mediating role of lifestyles., Methods: Data were obtained from the China Health and Retirement Longitudinal Study, which included 6879 participants. Cox proportional hazard models were used to evaluate the associations of ACEs and childhood SES with DS. Additive and multiplicative interactions between ACEs and childhood SES on DS were also examined. Causal mediation analyses were then conducted to quantify the mediating role of lifestyle factors in these associations., Results: During a median follow-up of 3.0 years, 1283 (18.7 %) participants were identified with DS. ACEs and low childhood SES were significantly associated with an increased risk of DS (ACEs [3 or more vs 0]: HR = 1.68, 95 % CI: 1.43-1.99; childhood SES [low vs high]: HR = 1.48, 95 % CI: 1.22-1.79). Compared to the no ACEs-moderate/high childhood SES group, the group with 1 or more ACEs-low childhood SES had the highest risk of DS (HR = 1.76, 95 % CI: 1.47-2.10). Significant additive interaction of ACEs with low childhood SES on DS was observed with relative excess risk due to an interaction of 1.21 (95 % CI: 0.27, 2.15). Sleep duration and smoking were identified as the potentially modifiable mediators., Conclusions: The findings highlight the importance of promoting initiatives to address ACEs, low childhood SES, and unhealthy lifestyles as part of DS prevention strategies., Competing Interests: Declaration of competing interest The authors declare that they have no competing interests., (Copyright © 2024 Elsevier B.V. All rights reserved.)

Introduction: Which adverse childhood experiences are causally associated with anxiety in adulthood is unclear. Sensitive Period Model states that early adverse experiences can influence anxiety levels in adulthood. However, it remains unknown which adverse experience is the most important early adverse factor for anxiety in adulthood, and whether early alleviation or aggravation of this adverse experience predicts a decrease or increase in anxiety levels in adulthood., Methods: A national cross-sectional survey was conducted from 20 June 2023 to 31 August 2023, with a total of 30,054 adults aged 18 years or older recruited on questionnaires that completed the Adverse Childhood Experiences Scale and Generalised Anxiety Disorder Scale. We used network analysis and computer simulation techniques to simulate aggravating and simulate alleviating interventions to observe changes in anxiety levels to identify early adverse experiences causally associated with anxiety levels in adulthood., Results: The results of both the network analysis and the nodeIdentifyR algorithm (NIRA) indicated that in the Adverse Childhood Experiences-Anxiety Network (ACE-GAD Network), being cursed and insulted (CUR) by parents in childhood was the most severe early adverse experience contributing to anxiety in adulthood. In particular, simulated aggravation interventions targeting CUR in young and middle-aged adults resulted in significantly higher levels of anxiety in adulthood., Conclusions: This suggests that preventing verbal curses or insults in childhood can be an early preventive measure for future anxiety interventions. This study has important theoretical and practical implications, providing new insights for early prevention of anxiety and family education., Competing Interests: Declaration of competing interest The authors declare that they have no known competing financial interests or personal relationships that could have appeared to influence the work reported in this paper., (Copyright © 2024 Elsevier B.V. All rights reserved.)

Background: Few studies have prospectively examined whether adverse childhood experiences contribute to suicide or substance-related mortality. Moreover, children are often exposed to multiple adversities making it critical to identify which clusters of adversities are most harmful for these outcomes. Accordingly, we investigated risk for suicide and substance-related mortality based on the number and clusters of adversities children were exposed to., Methods: Identifying information from 49,853 offspring born between 1959 and 1966 to participants in the Collaborative Perinatal Project was linked to the National Death Index to determine vital status by the end of 2016. We examined associations of the total number of adversities and five clusters of adversity (Low Adversity, Parental Harshness & Neglect, Family Instability, Poverty & Crowded Housing, Poverty & Parental Separation) with suicide and substance-related mortality., Results: Of the 45,207 participants in the analysis sample, 267 died by suicide and 338 by substance use. Participants who experienced Family Instability had a higher risk of dying by suicide (hazard ratio [HR] = 1.92, 95% CI: 1.32, 2.79) and substance use (HR = 1.50, 95% CI: 1.02, 2.19). Participants who experienced Poverty & Parental Separation were at higher risk of dying by substance use (HR = 1.85, 95% CI: 1.40, 2.45)., Limitations: Adversities with documented harm including physical and sexual abuse were not assessed in the study., Conclusions: Childhood adversity is associated with multiple types of self-injury mortality, suggesting shared etiology of risk for suicide and substance-related mortality. Research on interventions that target shared pathways linking childhood vulnerability to multiple causes of death may help reduce the long-term impact of adversities., Competing Interests: Declaration of competing interest None., (Copyright © 2024 The Authors. Published by Elsevier B.V. All rights reserved.)

Background: Despite potential protective and mitigating effects of positive childhood experiences (PCEs) on poor health outcomes, limited research has identified relevant PCEs and examined their individual and cumulative associations with weight status, or their mitigating effects on the associations between adverse childhood experiences (ACEs) and obesity in children. This study aims to develop an exploratory PCEs Index with the potential to protect against or mitigate the association between ACEs and unhealthy weight status., Methods: Data came from the Growing Up in New Zealand study. The analytic sample was restricted to those who provided obesity data at age 8 and one child per mother, resulting in a sample of 4,895 children. Nine individual ACEs and their cumulative scores, a newly developed PCEs index consisting of six individual PCEs and (their) cumulative scores, and an overweight/obesity variable were included in the analyses., Results: By age eight, experience of at least 3 PCEs was reported by 72.1% of the sample. However, the experience of the highest number of PCEs (5-6) was only reported by 23% of the sample. Four out of six assessed PCEs were associated with decreased likelihood of overweight/obesity. A dose-response effect was observed where experience of three or more PCEs was associated with decreased odds for obesity (AORs decreased from 0.77 for 3 PCEs to 0.54 for 5-6 PCEs). No consistent mitigating effects were found for individual PCEs; however interactions were found between reporting at least four of the six PCEs, experience of cumulative ACEs, and reduced odds for overweight/obesity at age 8., Conclusions: A critical number of PCEs may be required to mitigate the detrimental impacts of ACEs on weight status among children. These findings reinforce the need to consider a constellation of strength-focused ecological domains to alleviate the burden of childhood obesity, particularly for children exposed to multiple adversities., Competing Interests: Declarations. Ethics approval and consent to participate: Ethics approval for Growing Up in New Zealand Study was granted by the NZ Ministry of Health Northern Y Regional Ethics Committee, and all enrolled parents provided informed consent. Consent for publication: Not applicable. Competing interests: The authors declare no competing interests., (© 2024. The Author(s).)

Introduction: Exposure to adverse childhood experiences (ACEs) is associated with a range of poor long-term health outcomes, including multimorbidity and chronic pain. Epidemiological evidence underpins much of this relationship; however, psychophysical testing methods, such as quantitative sensory testing (QST), may provide valuable insights into potential mechanisms. Previous studies have shown inconsistent links between ACEs and QST, but the QST profiles of people with multimorbidity have not been reported. We hypothesise that exposure to ACEs is associated with lowered QST thresholds (ie, experience of pain with milder stimuli) and that this association is stronger in adults with multimorbidity and/or chronic pain. The ACE-MAP study is a cross-sectional feasibility study with the primary aim of assessing the feasibility and acceptability of the proposed study procedures. The secondary aim is to generate preliminary data to understand the impact of ACEs on QST thresholds., Methods and Analysis: We plan to recruit 40 participants, with 10 in each of the following groups: (1) chronic pain with multimorbidity; (2) chronic pain without multimorbidity; (3) multimorbidity without chronic pain; and (4) controls. Participants will complete a series of questionnaires (including on ACEs, chronic pain and long-term conditions) and will then take part in QST assessments. The primary study outcomes will include measures of feasibility and acceptability of the proposed study design. The secondary study outcomes will include exploratory analysis on the relationship between ACEs and QST thresholds., Ethics and Dissemination: The study was approved by the Scotland B Research Ethics Committee (reference: 24/SS/0031). Results from the study will be presented at scientific conferences, published in a peer-reviewed journal and shared with patients and members of the public through other media streams., Trial Registration Number: ISRCTN10049430., Competing Interests: Competing interests: None declared., (© Author(s) (or their employer(s)) 2025. Re-use permitted under CC BY. Published by BMJ Group.)

Introduction: Existing data on how history of trauma and adversity affects healthcare professionals is limited. This study sought to describe the prevalence of Adverse Childhood Experiences (ACEs) and Positive Childhood Experiences (PCEs) and their association with present-day workplace and wellbeing outcomes among a sample of healthcare teammates overall, as well as specifically among nurses. The paper also describes local trauma-informed care initiatives that supported study feasibility., Methods: Cross-sectional online survey data were collected in conjunction with promoting hospital-wide trauma-informed care training opportunities on two campuses that are part of an academic health system. Scales and items assessed independent variables PCEs and ACEs, and dependent variables including burnout, compassion fatigue, organizational belonging, adult resilience, access to support, and workplace violence (WPV). Demographic data were not collected to limit identifiability and encourage participation. Multivariable, hierarchical models regressed categorized total ACEs (ref 0, 1-3, 4-10) and total PCEs (ref 6-7, 3-5, 0-2) together on dichotomized dependent variables. Sub-analyses also adjusted for whether the participant was a nurse or reported serving in a different role., Results: Participants included 349 clinical and non-clinical employees, of whom 61.1% had at least one reported ACE, but 24.9% reported 4-10 ACEs. 29.9% reported only having 3-5 PCEs in their childhood, while 23.2% reported 0-2 positive childhood experiences. Even when adjusting for ACEs, having 0-2 PCEs was associated with significantly reduced odds of getting needed emotional or social support (AOR = 0.14, 95% CI: 0.07, 0.29). Having 0-2 PCEs relative to 6-7 PCEs was also significantly associated with greater odds of past 2-week compassion fatigue, a lower resilience score, and decreased odds of reported organizational belonging measures. Adjusting for ACEs and PCEs, nurses reported lower resilience and higher workplace violence compared to all other participant roles combined., Discussion: Teammate history of adversity was widespread and having fewer PCEs was associated with poorer adult workplace outcomes. These findings point to the value of a trauma-informed approach in healthcare, which offers healthcare organizations a framework for recognizing how trauma experiences affect wellbeing and intersect with the healthcare system, as well as how to create environments that are supportive of patients, staff, and providers., Competing Interests: LW was employed by 18 Cairns Consulting. The remaining authors declare that the research was conducted in the absence of any commercial or financial relationships that could be construed as a potential conflict of interest., (Copyright © 2025 Williamson, Daniel, Carter, Ridenhour, Pulgar, Gay and Debinski.)

Objectives: Major Depressive Disorder (MDD) is a severe and widespread psychiatric condition that affects individuals globally. Suicidal ideation is one of the key symptoms associated with this disorder. Numerous studies have explored the impact of adverse childhood experiences on the development of suicidal thoughts in adulthood. However, limited research focuses on the underlying mechanisms that mediate this relationship. Therefore, the present study aimed to investigate whether emotional reactivity, along with probabilistic and reinforcement learning (PRL), serves as a mediator in the relationship between adverse childhood experiences and suicidal ideation in Iranian patients with MDD., Method: The study included 201 inpatients diagnosed with MDD hospitalized in various psychiatric wards across Shiraz, Iran. Participants were selected using a convenient sampling method. Data were collected through the Probabilistic Reward Task, the Emotional Reactivity Scale, the Beck Scale of Suicidal Ideation, and the Modified Adverse Childhood Experiences - International Questionnaire. The collected data were analyzed using Pearson's correlation test and structural equation modeling with SPSS and AMOS 26., Results: Adverse childhood experiences were found to have a direct and significant relationship with suicidal ideation (p < .001). Additionally, emotional reactivity and PRL served as significant mediators in the relationship between adverse childhood experiences and suicidal ideation., Conclusion: Our findings indicate that various factors-including adverse childhood experiences, emotional reactivity, and PRL-contribute to the development of suicidal ideation in patients with major depressive disorder (MDD). Therefore, it is essential to consider these factors when developing therapeutic plans., Competing Interests: Declarations. Ethics approval and consent to participate: All experimental protocols were approved by the Institutional Review Board of the Shiraz University of Medical Sciences (ID: IR.SUMS.REC.1401.637) and all participants signed an informed consent prior to participation. Consent for publication: Not applicable. Competing interests: The authors declare no competing interests., (© 2025. The Author(s).)

We report the results of a scoping review of the literature investigating associations between positive childhood experiences (PCEs) and selected health outcomes to identify which have the highest level of research activity based on the indexed academic literature. Yielded articles underwent title/abstract (Ti/Ab) and full text screening utilizing inclusion/exclusion criteria. The review was guided by PCE categories from the Healthy Outcomes from Positive Experiences framework: relationships, environment, engagement, and emotional growth. The initial search yielded 8,919 unduplicated articles, 759 were retained following Ti/Ab review and 220 articles were retained after full text screening describing 795 tested associations across 23 PCE types in ten outcome categories. The outcomes most commonly examined were substance misuse (305 tested associations across 93 studies), suicidal behaviors (195 tested associations across 56 studies), and depression (112 tested associations across 55 studies). Physical health outcomes were less common (14 tested associations across six studies). Of the PCE exposures, relationships represented 415 of tested associations, 236 with environment, and 114 with social engagement. A significant body of research demonstrated associations between PCEs and health outcomes. While further research is needed, available research suggests that public health efforts to promote PCEs may have impact across multiple domains.

Background: Evidence suggests that screening and provider-led discussions of parental adverse childhood experiences (ACEs) may help identify at-risk families and be linked to positive health outcomes in caregivers and their children. However, the direct effect of ACEs screening and discussions on posttraumatic stress disorder (PTSD) has yet to be studied., Objectives: To determine if screening or provider-led discussions of parental ACEs are associated with inadvertent worsening of PTSD symptoms 1 week after screening., Research Design: Data was obtained as part of a cluster randomized controlled trial to examine the effects of ACEs screening and provider-led discussions on child health care utilization outcomes. Baseline surveys were completed before scheduled infant well child checks (WCCs). Providers were randomized into the standard of care or intervention (discussion) conditions. Intervention providers were trained in delivering brief trauma-informed discussions about the impact of ACEs on parenting during WCCs., Subjects: Caregivers in a pediatric primary care clinic serving predominantly Hispanic and low socioeconomically resourced families (N=179, 93% female, 87% Hispanic)., Measures: The Primary Care PTSD Screen for DSM-5 (PC-PTSD-5), Brief Resilience Scale (BRS), and ACEs screening were completed at baseline. PC-PTSD-5 was repeated 1-week after screening., Results: Mixed-effects ordinal logistic regression analysis of PTSD scores from baseline to 1-week postscreening with the full sample showed no significant effect of time [odds ratio (OR)=1.21, P=0.68], group (OR=1.68, P=0.33), or their interaction (OR=0.48, P=0.21)., Conclusions: Screening or brief discussion of ACEs with providers trained in trauma-informed care were not associated with worsening PTSD symptoms., Competing Interests: The authors have no conflicts of interest to disclose., (Copyright © 2024 The Author(s). Published by Wolters Kluwer Health, Inc.)

Purpose: Adverse childhood experiences (ACEs) increase the risk for poor mental health (MH) and substance use. We describe relationships between adolescents' ACEs, substance use, and poor MH occurring during the COVID-19 pandemic., Methods: We conducted a secondary analysis of data among U.S. high school students aged <18 years, who participated in the nationally representative Adolescent Behaviors and Experiences Survey. Data were collected from January to June 2021. Bivariate and multivariable analyses assessed associations between individual ACEs (physical, emotional abuse by parent or caregiver, parent or caregiver job loss, food insecurity, sexual violence, physical dating violence, or cyber bullying) and cumulative ACEs (0, 1-2, 3, 4+) experienced during the pandemic and substance use; stratified analyses assessed effects of poor MH on associations between ACEs and substance use., Results: Use of all substances was higher among adolescents with ACEs, particularly those who experienced both ACEs and poor MH during the COVID-19 pandemic. Prevalence of substance use was especially high among adolescents exposed to any sexual violence or physical dating violence. Compared to adolescents without ACEs, a higher percentage of adolescents with 4+ ACEs reported current use of alcohol (adjusted prevalence ratio [aPR], 5.32) or marijuana (aPR, 5.86), misuse of prescription pain medications (aPR, 8.82), binge drinking (aPR, 7.70), and increased alcohol (aPR, 6.54) or drug (aPR, 7.09) use during the pandemic., Discussion: The individual and combined impact of ACEs and MH on adolescent substance use reinforce the need for trauma-informed care and primary prevention of ACEs to prevent and mitigate poor MH and substance use among adolescents., (Published by Elsevier Inc.)

Introduction: Evidence suggested a link between early adversity and mental health problems. However, it is unclear how much adverse childhood experiences (ACEs) contribute to mental health problems because researchers have produced inconsistent findings. Therefore, the objective of this umbrella review was to combine the contradictory data regarding the effect of ACEs on the development of mental health problems later in life in the global context., Methods: PubMed, Embase, Scopus, Web of Sciences, Cochrane Database of Systematic Reviews, Scopus, and Google Scholar which reported the effect of ACEs on the development of mental health problems was searched. The quality of the included studies was assessed using the Assessment of Multiple Systematic Reviews (AMSTAR). A weighted inverse variance random-effects model was applied to find the pooled estimates. The subgroup analysis, heterogeneity, publication bias, and sensitivity analysis were also assessed., Results: Forty-three SRM with 14,707,614 study participants were included. The pooled effect of ACEs on the development of mental health problems later in life in the global context is found to be (AOR = 1.66 [1.46, 1.87]). Subgroup analysis based on country revealed (AOR = 1.67 [1.23, 2.11]) in UK, (AOR = 0.61 [0.41, 0.81]) in Canada, (AOR = 1.55 [1.40, 1.69]) in Brazil, (AOR = 5.65 [4.12, 7.18]) in Ethiopia, (AOR = 1.92 [1.45, 2.38]) in USA, (AOR = 2.30 [1.89, 2.72]) in Australia, and (AOR = 1.66 [1.46, 1.87]) in Ireland. While subgroup analysis based on types of adverse childhood adverse experience: domestic violence (AOR = 4.13 [1.96, 6.30]), maltreatment (AOR = 1.5 [0.79, 2.21]), physical abuse (AOR = 1.56 [1.43, 1.63]), sexual abuse (AOR = 2.07 [1.63, 2.51]), child abuse (AOR = 5.66 [4.12, 7.18]), parental mental health problem (AOR = 1.73 [1.39, 2.08]), bullying (AOR = 1.99 [1.69, 2.29], neglect (AOR = 2.11 [1.53, 2.69]), and parental divorce (AOR = 1.66 [1.46, 1.87]). Based on the type of mental health problem, the pooled effect size is 1.87 (1.45, 2.30) for depression and 1.67 (1.22, 2.13) for anxiety., Conclusion: This umbrella review revealed that ACE is significantly associated (with 66% increased risk) with anxiety and depression later in life in a global context. This association is most noticeable when one is subjected to domestic violence, maltreatment, physical abuse, sexual abuse, child abuse, parental mental health problems, bullying, neglect, and parental divorce. Childhood periods are a critical window of opportunity for reducing the risk of developing mental illness in the future and for implementing intervention measures. Preventing childhood maltreatment and addressing psychiatric risk factors can prevent psychopathology. Longitudinal studies are needed to optimize healthcare responses to ACEs. Increased awareness and public health interventions are needed to prevent childhood adversity and prevent mental problems among these victims. To optimize healthcare responses to unfavorable outcomes of childhood adversities, longitudinal and intervention research findings, more public health initiatives, and awareness are required., (© 2024 S. Karger AG, Basel.)