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Immigrants, asylum seekers, and refugees live with extreme stress, consistent vulnerability, and life-long health consequences. Children in these populations face an increased risk of poor mental health because of adverse childhood experiences (ACEs). To implement an ACE screening questionnaire for all migrant children aged < 19 years in a community shelter. The Model for Improvement. The Pediatric ACEs and Related Life Events Screener was implemented over 10 weeks in a community shelter. All children screened had at least 1 ACE. Initiation of screening led to the recognition of adverse experiences, thus allowing for mental health support and referrals to mental health specialists. This quality improvement project supports screening for ACEs in migrant children to uncover potential mental health concerns and provide targeted support, recognizing the long-term effects of trauma on their well-being. [ABSTRACT FROM AUTHOR]

Evaluation of relevant psychosocial variables is an important aspect of comprehensive, high-quality metabolic and bariatric surgery (MBS) care. Given the high rates of adverse childhood experience (ACEs) and other forms of trauma experienced later in life reported by individuals with class III obesity, it is time to apply the principles of trauma-informed care to the multidisciplinary care of MBS patients. This narrative review begins with a summary of the literature on the psychosocial functioning of individuals who present for MBS. Emphasis is placed upon the relationship between ACEs, class III obesity, and MBS. Trauma-informed care is defined, and its principles are applied to the MBS care continuum. The paper ends with a recommendation on how the field of MBS can integrate trauma-informed care into clinical practice and future research. [ABSTRACT FROM AUTHOR]

Autistic/ADHD individuals are increasingly recognised as a valid minority group, with consistent research demonstrating a higher prevalence of co-occurring mental health conditions such as PTSD, anxiety, depression, substance use, and eating disorders among other mental health challenges. Due to this, there is increasing focus on the adaptations required for Autistic and ADHD individuals of current therapeutic approaches such as Schema Therapy. Particular emphasis when creating these adaptations needs to include looking at the developmental experiences, social influences, and continued adversity faced by Autistic and ADHD individuals across the lifespan, and how the narrative around Autism and ADHD within psychotherapy in general needs to change. This paper critically examines the role of attachment, unmet needs, and adverse childhood experiences in Autistic and ADHD individuals and the subsequent impact on schema development and maintenance and mental health. This will include an overview of the current literature in this area, reconsideration of understandings of Autism and ADHD, particular therapeutic considerations and adjustments and importantly discussion around the wider societal changes that need to occur to prevent schema development and reinforcement across the lifespan. [ABSTRACT FROM AUTHOR]

AbstractObjectivesParticipantsMethodsResultsConclusionsAdverse childhood experiences (ACEs) have been linked to posttraumatic stress symptoms (PTSS), but the role of contextual factors remains underexplored. Therefore, this study examined the moderating effect of campus climate on associations between ACEs and PTSS and whether effects differ based on racial/ethnic identity.University students taking Psychology courses at a large public university in the Northeastern United States (n = 419).Participants completed a set of questionnaires assessing socio-demographics, ACEs, campus climate, and PTSS. Moderation analyses were conducted to test hypotheses.Significant 3-way interaction effects (e.g., ACEs x Campus Climate Subscales x Racial/ethnic Identity) were found for PTSS. Among White students, positive perceptions of campus climates buffered the effects of ACEs on PTSS severity. However, this protective effect was not observed among racial/ethnic minority students.The findings highlight campus climate as a contextual condition relevant to understanding mental health disparities among college students. [ABSTRACT FROM AUTHOR]

Multiracial people report higher mean Adverse Childhood Experience (ACE) scores and prevalence of anxiety than other racial groups. Studies using statistical interactions to test if associations between ACEs and anxiety are greater for this group than others have shown mixed results. Using data from waves 1 (1995-1997) through 4 (2008-2009) of the National Longitudinal Study of Adolescent to Adult Health (Add Health), we simulated a stochastic intervention over 1000 resampled datasets to estimate the race-specific cases averted per 1000 of anxiety if all racial groups had the same exposure distribution of ACEs as Whites. Simulated cases averted were greatest for the Multiracial group, (median = −4.17 cases per 1000; 95% CI; −7.42 to −1.86). The model also predicted smaller risk reductions for Black participants (−0.76; 95% CI, −1.53 to −0.19). CIs around estimates for other racial groups included the null. An intervention to reduce racial disparities in exposure to ACEs could help reduce the inequitable burden of anxiety on the Multiracial population. Stochastic methods support consequentialist approaches to racial health equity, and can encourage greater dialogue between public health researchers, policymakers, and practitioners. This article is part of a Special Collection on Mental Health. [ABSTRACT FROM AUTHOR]

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

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

Previous research has shown that exposure to adverse childhood experiences (ACEs) is associated with increased behavior problems in children. Few studies, however, have taken a multi-informant approach to examine how different factors involving both the child and caregiver affect children’s externalizing problems. Guided by Bowen’s Family Systems Theory, the current study examined how child age and gender, caregiver age, household income, child and caregiver adversity, and child and caregiver report of caregiver involvement were associated with children’s externalizing problems. The sample included 65 caregiver-child dyads recruited from community organizations in the Midsouth, United States. Youth were aged 6-12 years and primarily identified as Black or African American (95.45%) and as boys (54.55%). Two linear regression models were run with caregiverreport of child externalizing problems as the dependent variable in both models. One model focused on child variables, including child age, child gender, child adversity, and child-report of parental involvement, while the other centered caregiver variables, including caregiver age, income, caregiver ACEs, and caregiver report of their own parental involvement. Only the caregiver model was significant, with more caregiver ACEs related to higher child externalizing problems. None of the other independent variables were related to child externalizing problems. These results demonstrate the impact of caregiver’s history of adversity on child functioning. Interventions that target children’s externalizing problems may benefit from incorporating an assessment of parent adversity history. Future research should explore underlying mechanisms that may explain this association to identify modifiable factors that could be included in treatments for youth experiencing externalizing problems. [ABSTRACT FROM AUTHOR]

Background: Individuals who experience childhood trauma may be more likely to misuse substances. The influence of social risk factors increases the frequency of opioid use. Understanding the linkages between childhood trauma, opioid use disorder, and social risk factors has the potential of improving poor health outcomes. The performance of specific role groups on office-based addition teams in documenting social risk factors in the electronic medical record had not been studied. Methods: This retrospective chart review was conducted across three primary care practices at an urban academic medical center. Results: The majority of our sample reported at least one social risk factor. Those patients with an advanced practice nurse and/or navigator on their team were more likely to report food insecurity and to have documentation related to involvement with the legal system. Recovery coaches were most likely to document the lack of housing stability as compared to other members of the team. Conclusions: The incidence of documentation related to housing stability, food insecurity, and involvement with the legal system for patient's engaged in an OBAT program should alert interprofessional clinicians on the team to assess for a history of adverse childhood experiences. [ABSTRACT FROM AUTHOR]

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

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

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

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

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

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

Amid evolving needs of students and institutions comes a logical investigation of innovative ways to provide advanced level students with affordable and flexible education. The introduction of COVID-19 has changed the ways in which we have considered the delivery of graduate education. Graduate students with full-time jobs, families, and other obligations deserve alternative ways of attaining advanced degrees. This review will investigate the appropriateness of Competency-based education (CBE) in counselor education programs, and the strengths and limitations it might hold in relation to accreditation requirements by the Council for the Accreditation of Counseling and Related Education Programs (CACREP). [ABSTRACT FROM AUTHOR]

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

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

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

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

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

BackgroundAdverse childhood experiences (ACEs) influence depressive symptoms. Depressive symptoms were heterogeneous from the perspective of life course.ObjectiveTo explore the effects of ACEs on the trajectory of depressive symptoms in China.ParticipantsThe data is from the 5 waves of the China Health and Retirement Longitudinal Study (CHARLS) and the 2014 Life Course Survey of it. A total of 17,106 individuals were included, without the people younger than 45 years.MethodsWe dealt with the missing values using multiple interpolation. The CESD-10 and a 12-item questionnaire was used to assess the depressive symptom and ACEs, respectively. We used group-based trajectory modelling (GBTM) to identify the 10-year depressive-symptoms. Logistic regression models were used to explore associations between the trajectory and the ACEs.ResultsFive depressive-symptom trajectories were identified based on the GBTM analysis (BIC = 540533.61; AIC = 540347.68; n = 17,106). Compared to the participants without depressive symptoms, the older adults who have more adverse childhood experiences have more odds of being in the other four groups, and the more ACEs the older adults experienced, the more likely it is.ConclusionThe 10-year depressive-symptoms trajectories among middle-aged and older adults in China were different from previous features. The significance of a life-course intervention plan to prevent childhood adversity and the related mental health damage in later life is demonstrated by the long-term influence of ACEs on depressive symptoms.

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

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

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

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

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

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

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

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

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

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

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

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

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

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

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

A mixed-methods study was carried out to better characterize the life course experiences, with a focus on trauma, of men who had perpetrated gun violence and other violent crime, and who had multiple arrests and incarcerations. A small sample of 13 men with a history of a minimum of 12 arrests each as well as histories of gun violence, other violent crime, and incarceration was drawn from a social program providing cognitive therapy and job skills training in a major urban center. Participants completed the Adverse Childhood Experiences Questionnaire and Post Traumatic Stress Disorder Checklist for DSM-5 and completed an in-depth interview. Results demonstrated that the participants had extraordinarily significant levels of trauma exposure but that they had minimal avowed trauma symptoms. The exception is that every participant demonstrated a clinically relevant score on the Arousal subscale (Criterion E). Participants in interviews discussed a number of characteristics of their developmental years. They described near constant exposure to traumatic events, in some cases starting from very young ages. Most participants described a personal experience of numbing or desensitization to their experiences. They described the impact of gangs on both protecting them from trauma and exposing them to trauma, and they described their subsequent experiences of incarceration. They offered recommendations for strategies to minimize violent crime in communities. [ABSTRACT FROM AUTHOR]

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

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

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

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