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The objective of this scoping review was to describe and synthesize the measures, methods, and key findings of published quantitative research examining the influence of child maltreatment (i.e., abuse and/or neglect) and adult trauma exposure on mental health symptoms among women Veterans. A systematic search from database inception to June 2023 generated 18,861 unique articles retrieved and independently screened for eligibility. A total of 21 articles met pre-established inclusion criteria: (a) quantitative data and results within a sample or subsample of U.S. women veterans, (b) published in a peer-reviewed journal, and (c) examining variables of interest simultaneously (i.e., child maltreatment, adult trauma exposure, mental health symptom) in quantitative analyses. Reviewed literature showed a lack of uniformity in measurement and methodologies to evaluate women veterans' lifetime trauma exposure in relation to mental health. Studies most frequently used self-report survey data to evaluate exposure to child maltreatment and/or adult trauma with convenience samples of women veterans (52.4%, n  = 11) and examined depressive and/or posttraumatic stress symptomatology. Findings demonstrate the need for additional research attending to the interplay between child maltreatment and adult trauma exposures in relation to women veterans' mental health using comprehensive assessment, longitudinal methods, and understudied as well as more representative samples., Competing Interests: Declaration of Conflicting InterestsThe author(s) declared the following potential conflicts of interest with respect to the research, authorship, and/or publication of this article: The views expressed in this article are those of the authors and do not necessarily reflect the position or policy of the Department of Veterans Affairs or the United States government. The authors had full access to the data in the study and take responsibility for the integrity of the data and the accuracy of the data analysis. No financial disclosures were reported by the authors of this paper.

Background: Cognitive deficits might contribute to the elevated risk of life-course psychopathology observed in maltreated children. Leading theories about the links between childhood maltreatment and cognitive deficits focus on documented exposures (objective experience), but empirical research has largely relied on retrospective self-reports of these experiences (subjective experience), and the two measures identify largely non-overlapping groups. We aimed to test the associations of objective and subjective measures of maltreatment with cognitive abilities within the same individuals., Methods: We studied a cohort of individuals from the US Midwest with both objective, court-documented evidence of childhood maltreatment and subjective self-reports of individuals' histories at age 29 years. Between the ages of 29 years and 41 years, participants were assessed with a comprehensive set of cognitive tests, including tests of general verbal intelligence (Quick Test and Wide Range Achievement Test-Revised [WRAT]), non-verbal intelligence (Matrix Reasoning Test [MRT]), executive function (Stroop Test and Trail Making Test Part B [TMT-B]), and processing speed (Trail Making Test Part A [TMT-A]). Participants were also assessed for psychopathology (Center for Epidemiologic Studies Depression Scale and Beck Anxiety Inventory). We tested the associations between objective or subjective measures of childhood maltreatment with cognitive functions using ordinary least squares regression. To test whether cognitive deficits could explain previously described associations between different measures of maltreatment and subsequent psychopathology, we re-ran the analyses accounting for group differences in the Quick Test. People with lived experience were not involved in the research or writing process., Findings: The cohort included 1196 individuals (582 [48·7%] female, 614 [51·3%] male; 752 [62·9%] White, 417 [34·9%] Black, 36 [3·8%] Hispanic) who were assessed between 1989 and 2005. Of the 1179 participants with available data, 173 had objective-only measures of childhood maltreatment, 492 had objective and subjective measures, 252 had subjective-only measures, and 262 had no measures of childhood maltreatment. Participants with objective measures of childhood maltreatment showed pervasive cognitive deficits compared with those without objective measures (Quick Test: β=-7·97 [95% CI -9·63 to -6·30]; WRAT: β=-7·41 [-9·09 to -5·74]; MRT: β=-3·86 [-5·86 to -1·87]; Stroop Test: β=-1·69 [-3·57 to 0·20]; TMT-B: β=3·66 [1·67 to 5·66]; TMT-A: β=2·92 [0·86 to 4·98]). The associations with cognitive deficits were specific to objective measures of neglect. In contrast, participants with subjective measures of childhood maltreatment did not differ from those without subjective measures (Quick Test: β=1·73 [95% CI -0·05 to 3·50]; WRAT: β=1·62 [-0·17 to 3·40]; MRT: β=0·19 [-1·87 to 2·24]; Stroop Test: β=-1·41 [-3·35 to 0·52]; TMT-B: β=-0·57 [-2·69 to 1·55]; TMT-A: β=-0·36 [-2·38 to 1·67]). Furthermore, cognitive deficits did not explain associations between different measures of maltreatment and subsequent psychopathology., Interpretation: Previous studies based on retrospective reports of childhood maltreatment have probably grossly underestimated the extent of cognitive deficits in individuals with documented experiences of childhood maltreatment, particularly neglect. Psychopathology associated with maltreatment is unlikely to emerge because of cognitive deficits, but might instead be driven by individual appraisals, autobiographical memories, and associated schemas., Funding: National Institute of Justice, National Institute of Mental Health, Eunice Kennedy Shriver National Institute of Child Health and Human Development, National Institute on Aging, Doris Duke Charitable Foundation, and National Institute for Health and Care Research., Competing Interests: Declaration of interests We declare no competing interests., (Copyright © 2024 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.)

Objective: Utilizing national longitudinal data, this study examines how polygenic depression risk and childhood abuse interactively influence the life-course development of depressive conditions from middle to late adulthood., Method: Data from 7512 participants (4323 females and 3189 males) of European ancestry aged 51-90, retrieved from the U.S. Health and Retirement Study (1992-2020), were analyzed. Childhood physical abuse and polygenic depression score were the primary predictors. Depressive symptoms were assessed using the Center for Epidemiologic Studies-Depression (CESD) scale, and clinical depression risk was a binary indicator. Growth-curve linear mixed and logit mixed-effects models were conducted for analysis., Results: Increasing polygenic depression scores were associated with elevated CES-D levels and potential risks of clinical depression. Males experienced more detrimental effects of childhood abuse on depression development from ages 51 to 90 years. In contract, non-maltreated females generally exhibited higher depressive symptoms and clinical depression risk than males. A significant interactive effect was found between polygenic depression risk and childhood abuse among males. Higher depression levels and clinical risk were observed with increasing polygenic depression score among maltreated males, surpassing those of females with standardized polygenic score ≥0 from age 51 to 90 years., Conclusions: The interaction between childhood abuse and genetic factors significantly shaped lifelong depression trajectories in males, while the negative impact of abusive parenting remained constant regardless of polygenic depression risk among females. Individualized prevention and intervention strategies could be crucial in mitigating lifelong depression development, especially for high-genetic-risk males with a history of childhood physical abuse., Competing Interests: Declaration of competing interest All authors have completed and submitted the ICMJE Form for disclosure of potential conflicts of interest and none were reported., (Copyright © 2024. Published by Elsevier Inc.)

Background: Childhood sexual abuse can increase both body weight and inflammation later in life. Higher weight or faster changes in weight, as measured by changes in body mass index (BMI), may mediate the relationship between childhood sexual abuse and inflammation, however, most studies to date have used a cross-sectional design limiting causal inferences., Objective: The current study aimed to investigate the interrelationships between childhood sexual abuse, BMI, and C-reactive protein (CRP) and interleukin-6 (IL6)., Participants and Setting: Data from 461 adults who participated in the Midlife in the United States (MIDUS) study were utilized., Methods: Growth curve modeling was used to test initial levels of BMI and changes of BMI over an 18-year period as mediators linking childhood sexual abuse to CRP and IL6., Results: Sexual abuse was not significantly associated with the initial level of BMI; however, sexual abuse was associated with the slope of BMI (b = 0.072, p = .006). BMI intercept (b = 0.080, p = .001) and slope (b = 0.240, p = .002) predicted IL6 values whereas the slope of BMI (b = 0.398, p = .033) but not intercept predicted CRP values. The indirect effect from sexual abuse to IL6 through BMI slope was significant (b = 0.017, 95 % [CI.001, 0.033]) while the indirect effect from sexual abuse to CRP through BMI slope was not significant (b = 0.028, 95 % [CI -0.004, 0.061])., Conclusion: Childhood sexual abuse was indirectly associated with IL6 through rates of change in BMI over time., Competing Interests: Declarations of interest none, (Copyright © 2024 Elsevier Ltd. All rights reserved.)

According to biopsychosocial models, experiencing parental child abuse increases susceptibility to adulthood psychopathology. However, there is a paucity of studies examining potential mechanisms of the parental child abuse and adulthood psychopathology relationship. The purpose of the current study was to determine if Time 2 (T2) trait self-esteem mediated levels of Time 1 (T1) retrospectively recalled parental child abuse predicting (T3) past-year major depressive disorder (MDD), generalized anxiety disorder (GAD), panic disorder (PD), alcohol use disorder (AUD), and substance use disorder (SUD) symptoms. The 18-year Midlife Development in the United States (MIDUS) study included participants (N = 3294; T1 average age of 45.62 years) assessed at three different time points, each spaced about nine years apart. We performed structural equation mediation modeling analyses to determine how maternal and paternal child abuse at T1 would independently predict T3 MDD, GAD, PD, AUD, and SUD symptoms. We also examined whether T2 self-esteem mediated these relations while controlling for adulthood T1 psychopathology symptoms, demographics, socioeconomic status, somatic symptoms, and parental psychopathology. Consistent with our hypotheses, higher T1 maternal and paternal abuse predicted increased T3 GAD, PD, AUD, and SUD symptoms via diminished T2 self-esteem as the mediator (% proportion mediated = 33.0-100). However, childhood paternal, but not maternal, abuse predicted adulthood MDD symptoms via reduced self-esteem. Findings remained after adjusting for covariates. Our research highlights the importance of understanding retrospectively recalled parental child abuse-adulthood psychopathology relations, their potential mechanisms, and self-esteem as a malleable treatment target for adults with heightened child abuse., Competing Interests: Declaration of competing interest None of the authors have any conflict of interest., (Copyright © 2024 Elsevier B.V. All rights reserved.)

Background: Childhood sexual abuse (CSA) is associated with health problems, including cardiometabolic outcomes. Findings directly linking CSA to cholesterol levels are mixed, and identifying mediating pathways is the next logical step. Body mass index (BMI) is one possible mediator, given its association with both CSA and cardiometabolic outcomes. Gendered effects of CSA indicates that BMI may operate differently in men and women., Objective: We tested BMI as a mediator linking CSA to high-density lipoprotein (HDL) and low-density lipoprotein (LDL) using a multiple group structural equation model stratified across gender to test the indirect effects., Participants and Setting: We utilized a sample of 1054 adults (54.7 % women) from the study of Midlife Development in the United States, who were drawn from the general population., Methods: Using two waves of data, participants responded to a questionnaire assessing CSA, provided measurements from which to calculate BMI, and a fasting blood sample from which cholesterol levels were measured., Results: The indirect effects in the overall sample yielded a significant effect from CSA to HDL via BMI (β = -0.03, 95 % CI [-0.050, -0.010]), but not LDL (β = 0.006, 95 % CI [-0.002, 0.014]). The indirect effect from CSA to HDL cholesterol was significant among women (β = -0.04, 95 % CI [-0.066, -0.012]) only. Indirect effects to LDL among both genders were both non-significant., Conclusions: BMI appears to be a possible mediator linking CSA to lower HDL cholesterol among women suggesting BMI could be a point of trauma-informed prevention and intervention especially impactful., (Copyright © 2024. Published by Elsevier Ltd.)

Background: Empirical studies have demonstrated associations between ten original adverse childhood experiences (ACEs) and multiple health outcomes. Identifying expanded ACEs can capture the burden of other childhood adversities that may have important health implications., Objective: We sought to identify childhood adversities that warrant consideration as expanded ACEs. We hypothesized that experiencing expanded and original ACEs would be associated with poorer adult health outcomes compared to experiencing original ACEs alone., Participants: The 11,545 respondents of the National Longitudinal Surveys (NLS) and Child and Young Adult Survey were 48.9 % female, 22.7 % Black, 15.8 % Hispanic, 36.1 % White, 1.7 % Asian/Native Hawaiian/Pacific Islander/Native American/Native Alaskan, and 7.5 % Other., Methods: This study used regression trees and generalized linear models to identify if/which expanded ACEs interacted with original ACEs in association with six health outcomes., Results: Four expanded ACEs-basic needs instability, lack of parental love and affection, community stressors, and mother's experience with physical abuse during childhood -significantly interacted with general health, depressive symptom severity, anxiety symptom severity, and violent crime victimization in adulthood (all p-values <0.005). Basic needs instability and/or lack of parental love and affection emerged as correlates across multiple outcomes. Experiencing lack of parental love and affection and original ACEs was associated with greater anxiety symptoms (p = 0.022)., Conclusions: This is the first study to use supervised machine learning to investigate interaction effects among original ACEs and expanded ACEs. Two expanded ACEs emerged as predictors for three adult health outcomes and warrant further consideration in ACEs assessments., (Copyright © 2024 Elsevier Ltd. All rights reserved.)

Background: Although previous research has established a relationship between childhood trauma and later-life anxiety and depression symptoms in American Indian samples, less is known about protective factors that may reduce the strength of this relationship., Objective: The purpose of the present study was to investigate in a sample of American Indian adults, whether age moderates the relationship between self-compassion and poor mental health associated with childhood trauma., Participants and Setting: Seven hundred and twenty-nine self-identifying American Indian adults (age 18-95) residing in the United States completed an online survey., Method: All participants were self-identifying American Indian adults recruited via Qualtrics, which utilized targeted recruiting through managed research panels. Participants self-reported age, gender, income, and completed measures of self-compassion, childhood trauma, and symptoms of anxiety and depression., Results: Lower self-compassion predicted higher levels of both anxiety symptoms (β = -2.69, R 2 change = 0.24, t(718) = -15.92, p < .001) and depression symptoms (β = -2.23, R 2 change = 0.26, t(718) = -16.30, p < .001). In line with our hypothesis, there was a significant three-way interaction between age, childhood trauma exposure and self-compassion in predicting later-life symptoms of anxiety (β = -0.68, t(712) = -3.57, p < .001, R 2 change = 0.01) and depression (β = -0.54, t(712) = -3.32, p = .001, R 2 change = 0.01)., Conclusions: The findings indicate that for older American Indian adults, self-compassion may be a particularly promising protective factor for symptoms of depression for those who have experienced high levels of childhood trauma, and for symptoms of anxiety regardless of childhood trauma exposure., (Copyright © 2024 Elsevier Ltd. All rights reserved.)

Objective: This national study examined whether different types of interpersonal violence and mental disorders were associated with greater risk for attempted suicide among bisexual women than heterosexual women., Method: Data were used from participants in Wave II of the National Epidemiologic Survey on Alcohol and Related Conditions in the United States of America who identified as female and either heterosexual or bisexual ( N = 19,261; 71% White). Logistic regression models tested the main and interactive effects of three types of interpersonal violence (i.e., childhood abuse, childhood neglect, or intimate partner violence [IPV]), four types of mental disorders (i.e., mood, anxiety, substance use, and posttraumatic stress) and sexual orientation (i.e., bisexual vs. heterosexual) on attempted suicide. A post hoc logistic regression also tested the main and interactive effects of four types of anxiety disorders (i.e., panic disorder, social phobia, specific phobia, and generalized anxiety disorder [GAD]) and sexual orientation on attempted suicide., Results: Sexual orientation moderated the impact of childhood neglect, IPV, and anxiety disorders on attempted suicide. Bisexual women who experienced childhood neglect, IPV, or an anxiety disorder had 3.75, 1.43, and 6.24 greater odds, respectively, of attempted suicide, compared to heterosexual women who reported these problems. Additionally, bisexual women who had GAD had 1.66 greater odds of attempting suicide compared to heterosexual women who had GAD., Conclusions: Findings elucidate factors that may increase suicide risk in vulnerable populations as called for by the Centers for Disease Control and Prevention's suicide prevention strategic plan. (PsycInfo Database Record (c) 2024 APA, all rights reserved).

Objectives: Childhood abuse has been extensively studied in relation to later-life health, yet relatively little attention has been given to understanding the nuanced dynamics across victim-perpetrator relationships. This study addresses this gap by identifying typologies of familial perpetrators of childhood abuse in a national sample and examining their associations with various health outcomes, including physical and mental health as well as substance abuse., Methods: We used 2 waves of data from the Midlife in the US Study (n = 6,295, mean age = 46.9 at baseline). The analysis was completed in 3 stages. Using Latent Class Analysis (LCA), we identified subpopulations of victims with distinct familial perpetrator histories. With assigned LCA memberships and propensity score weighting, we investigated the extent to which specific victim-perpetrator relationships are associated with health outcomes measured at baseline and a 10-year follow-up adjusting for other early-life risks. We evaluated whether the observed associations differ across the waves., Results: Parental and sibling abuse commonly co-occur, surpassing the occurrence of single perpetrators. Although minimal health disparities are evident between sibling-only abuse and no/little abuse groups at baseline, parent-only abuse is associated with compromised health outcomes. Severe abuse from both siblings and parents is linked to the most adverse health outcomes. At the follow-up survey, the associations between familiar abuse and health outcomes weakened, particularly for substance abuse., Discussion: This study, delving into family relationships, family violence, and health disparities, provides new evidence to augment our comprehension of the enduring link between childhood abuse and health within the family context., (© The Author(s) 2024. Published by Oxford University Press on behalf of The Gerontological Society of America. All rights reserved. For commercial re-use, please contact reprints@oup.com for reprints and translation rights for reprints. All other permissions can be obtained through our RightsLink service via the Permissions link on the article page on our site—for further information please contact journals.permissions@oup.com.)

Child maltreatment (CM) is associated with multiple adverse health outcomes. Hence, there is a great need to identify factors that promote resilience in CM survivors. Mentorship may promote positive coping in CM survivors, but this may vary by health outcome and mentor/mentee characteristics. Among participants in a United States nationally representative sample, the National Longitudinal Study of Adolescent to Adult Health, who retrospectively reported any CM before age 18 (sexual, emotional or physical, abuse or neglect; N = 3364), we examined associations between mentorship during adolescence and body mass index (BMI), obesity, and depressive symptoms at ages 24-32 (in 2008-2009). We utilized linear regression and predictive margins with complex sample weighting. Models were stratified by sex and race/ethnicity. Thirty-one percent and 40% of participants' most influential mentor was inside and outside the family, respectively, and 29% reported no mentor. Any mentorship was associated with decreased depressive symptoms in females (adjusted beta for any mentor = -0.78, 95% CI:-1.54,-0.02). By contrast, any mentorship was associated with increased adiposity, namely among Latinas (adjusted beta for BMI = 2.23, 95% CI:0.45,4.02, adjusted risk ratio for obesity = 1.42, 95% CI:1.03,1.97). The influence of mentorship in CM survivors is heterogeneous. While mentorship was associated with reduced psychopathology, it was also linked with worse physical health, underscoring that mentoring does not necessarily promote long-term resilience to physical health outcomes, particularly in minorities. A better understanding of how mentors influence specific mentee behaviors may be important in informing how mentors can promote better physical health and lower obesity risk among CM survivors., Competing Interests: Declaration of Competing Interest This work was supported by the National Heart, Lung, and Blood Institute [grants R01HL125761-05S1 and T32HL130025]. The funder had no role in the design, collection, analysis or interpretation of data; in the writing of the manuscript; or in the decision to submit the article for publication. The authors have no other conflicts of interest or financial disclosures to report., (Copyright © 2022 Elsevier Inc. All rights reserved.)

This study examined the moderating role of alcohol use on the association between adverse childhood experiences (ACEs) and intimate partner violence (IPV) perpetration among Black men in the United States. We conducted bivariate and logistic regression analyses using data from Wave 2 of the National Epidemiologic Survey of Alcohol and Related Conditions (NESARC). Bivariate results revealed significant relationships between eight of the 10 ACE factors physical neglect; emotional, physical and sexual abuse; witnessing a mother being abused; and having a parent guardian with an alcohol and drug problem and who was incarcerated and IPV perpetration. Similarly, examination of the relationship between ACEs and alcohol use in adulthood also revealed significant associations, with the exception of exposure to emotional neglect, emotional and sexual abuse, and witnessing a mother being abused. Findings from the logistic regression models revealed that alcohol use significantly moderated the relationship between ACEs and IPV perpetration, but only for men exposed to 1, 2, and ≥4 adversities in childhood. However, alcohol use appeared to exacerbate the relationship between ACEs and IPV perpetration for men without childhood adversity. Implications for practice, policy, and areas for further research are discussed.

Background: Child maltreatment is prevalent in the United States and carries long-term consequences. Parental substance use may have associations with child maltreatment. It is unclear whether co-occurring parental substance use aggravates childhood psychiatric outcomes related to suspected maltreatment., Objective: To compare psychiatric and healthcare utilization outcomes in children with suspected abuse reports, with and without documented parental substance use., Participants and Setting: Retrospective cohort study (n = 2831) of children with suspected abuse/neglect (SANC) reports filed in the electronic health record between January 1, 2000 and January 1, 2016. Children who had SANC reports referencing parental substance use (n = 458) were compared with those who had SANC reports that did not reference substance use (n = 2346)., Methods: Outcome data included ICD-10 coded medical and psychiatric diagnoses and healthcare utilization., Results: Compared to children who had a SANC report filed without parental substance use, children with parental substance use in a SANC showed significantly lower age-adjusted odds of anxiety disorder, mood disorder and externalizing disorder, and higher odds of a substance use disorder diagnosis. They were also less likely to present to an emergency department visit for any reason in the year prior to the report., Conclusions: Children with exposure to parental substance use in a household where parental abuse or neglect was suspected had lower odds of adverse psychiatric outcomes as compared to children with suspected report of abuse or neglect unrelated to parental substance use. The present findings highlight the complex interplay of psychosocial factors associated with outcomes of childhood maltreatment., (Copyright © 2021 Elsevier Ltd. All rights reserved.)

Objective: To evaluate the association between obesity and history of childhood trauma in an effort to define implications for the provider-patient relationship and possible causes of failure of obesity treatment., Methods: Multisite survey developed by the Patient-Centered Outcomes Research Institute Learning Health Systems Obesity Cohort Workgroup consisting of 49 questions with 2 questions focusing on history of being a victim of childhood physical and/or sexual abuse was mailed to 19,964 overweight or obese patients. Data collection for this survey occurred from October 27, 2017, through March 1, 2018., Results: Among the 2211 surveys included in analysis, respondents reporting being a victim of childhood abuse increased significantly with obesity (23.6%, 26.0%, 29.1%, and 36.8% for overweight, class I, class II, and class III obesity, respectively; P<.001). A higher percentage of those who reported being a victim of childhood abuse noted that their weight issues began at an earlier age (P=.002) and were more likely to have weight-related comorbidities (P<.001), even after controlling for body mass index. Impacting physician counseling on weight loss, patients who were childhood victims of abuse reported lower self-esteem (P<.001), were more likely to feel judged by their health care providers (P=.009), and less likely to feel being treated with respect (P=.045)., Conclusion: Overall, being a victim of childhood abuse was significantly associated with obesity, lower self-esteem and negative experiences interacting with health care providers. Health care providers should receive training to ensure open and nonjudgmental visits with obese patients and consider the role of trauma survivorship issues in patients' development of obesity and health care experiences., (Copyright © 2020 Mayo Foundation for Medical Education and Research. Published by Elsevier Inc. All rights reserved.)

Background: Research has well-established that childhood maltreatment is associated with depressive and social anxiety symptoms in adults. Emotional support has been proposed as a mediator, yet research investigating the unique contributions of emotional support from friends, family members, and romantic partners in adulthood is sparse., Objective: The current study tested emotional support from family, friends, and romantic partners as mechanisms linking childhood maltreatment to depressive and social anxiety symptoms in adults., Participants and Setting: Participants for the current study (N = 798) included adults in a committed romantic relationship and completed both the second wave of the National Survey of Midlife Development in the United States (MIDUS 2) as well as the MIDUS 2 biomarker follow-up project. Emotional support from family, friends, and romantic partners was measured at MIDUS 2 and mental health symptoms were reported at the MIDUS 2 biomarker follow up., Results: Emotional support from friends was identified as a mechanism from maltreatment to social anxiety symptoms (ß = .04, 95 % CI [.019, .066]), emotional support from family members was a mechanism to depressive symptoms (ß = .09, 95 % CI [.045, .146]), and emotional support from romantic partners was a mechanism for both depressive (ß = .02, 95 % CI [.005, .048]) and social anxiety symptoms (ß = .03, 95 % CI [.008, .048])., Conclusions: The current study documents that emotional support may be a mechanism linking childhood maltreatment to mental health symptoms. Emotional support from different sources appear to be of significant importance in understanding adult mental health. Clinical implications are discussed., (Copyright © 2020 Elsevier Ltd. All rights reserved.)

Background: Parenting a child with a disability has been shown to take a toll on physical health in mid to late life. However, the additional impact of a history of childhood maltreatment has not been explored., Objective: This study examined the moderating effect of exposure to childhood maltreatment on the longitudinal associations between parenting a child with a disability and physical health. We also examined whether this interaction was conditional on parent gender., Methods: Data were obtained from 3178 participants in the Midlife in the United States (MIDUS) study. We used linear mixed modeling to estimate the independent and interactive effects of a history of childhood maltreatment, parenting a child with a disability, and parent gender on physical health over three waves of assessment spanning nearly two decades. We used three distinct measures of health including a composite based on two self-rated health items, chronic conditions, and functional limitations., Results: Key results showed that a history of childhood maltreatment exacerbated the adverse health effect of parenting a child with a disability for mothers, but not fathers., Conclusions: Findings suggest that a history of early maltreatment may create a context that makes it more difficult to cope with the demands of caring for a child with a disability, and the accompanying stress has a detrimental effect on health., (Copyright © 2020 Elsevier Ltd. All rights reserved.)

Targeted screening for sexual abuse is needed for social workers to accurately identify those at risk. Drawing on a cumulative disadvantage framework, this study investigates how parental addictions, parental mental illness, and exposure to domestic violence, both individually and cumulatively, are associated with childhood sexual abuse (CSA). Two waves of regionally representative data were analyzed. Bivariate and logistic regression analyses were conducted using the 2010 Brief Risk Factor Surveillance Survey (BRFSS) (n = 9,241 men, n = 13,627 women) and replicated using the 2012 BRFSS (n = 11,656 men, n = 18,145 women). The 2010 data indicated that 8.5 percent of men who had endured all three childhood adversities reported that they had experienced CSA, compared with 0.6 percent of men who did not experience any of these adversities. Levels of CSA for women in 2010 were 28.7 percent for those experiencing all three risk indicators, and 2.1 percent for women with no risk indicators. Results were similar in the BRFSS 2012. Those with two or more risk factors had between five- and eightfold higher odds of CSA. Social workers may be able to decrease false positives if they screen for CSA based on the presence of two or more risk factors., (© 2020 National Association of Social Workers.)

Young men who have sex with men (YMSM) have the highest burden of sexually transmitted infections (STIs), including HIV. Childhood sexual abuse (CSA) is a risk factor for high-risk sexual behavior and STI acquisition. Studies that have explored sexual behavior based on the type of reported sexual abuse are limited. This study aimed to further understand current sexual behaviors and perceptions among YMSM that have experienced different types of CSA. Sixteen YMSM who were survivors of CSA were interviewed utilizing a phenomenological conceptual framework and methodology. Thematic findings were divided into two parts. Part I gave an overview of the entire sample, and themes were as follows: unprotected oral sex used to evaluate penile abnormalities, trust promoting unprotected sex, and alcohol and other drugs not cited as the reason for casual sex. Part II demonstrated the differences among those with a history of CSA involving non-penile-anal intercourse and those with a history of CSA involving penile-anal intercourse. The major themes in Part II were that victims of CSA involving penile-anal intercourse reported the following: a hypersexual self-definition, an STI diagnosis and noncondom use history, and a third sexual partner during sexual activity. Based on the findings, early life experiences such as CSA should be considered when developing preventative sexual health strategies and individuals who experienced penetrative sexual abuse may have different needs which should be further explored.

Objective: The present study had three major aims: 1) To identify sub-groups of adults with differing combinations of childhood maltreatment exposures, 2) to understand the association of childhood maltreatment sub-group membership with subjective sleep quality in midlife, and 3) to assess poor sleep quality in midlife as a mechanism between childhood maltreatment sub-group membership and physical functional limitations in late adulthood. Design: Data come from the Biomarker project of the Midlife Development in the United States study ( n  = 1251). Outcome measures: The Pittsburgh Sleep Quality Index (Buysse et al., 1989) was used to assess sleep quality in midlife. Functional limitations in late adulthood were measured using a version of the SF-36 (Brazier et al., 1992). Results: Two vulnerable childhood maltreatment sub-groups emerged (Physical and Emotional Maltreatment Sub-group, n  = 49, and Sexual Abuse Sub-group, n  = 105) and a normative sub-group ( n  = 1087; low exposure to childhood maltreatment). Poor sleep quality in midlife mediated the association between both maltreatment sub-groups and functional limitations in late adulthood. Conclusion: Results highlight the role of sleep in linking childhood maltreatment with functional impairments in adulthood and offer a potential target for interventions to improve quality of life in older adults.

Children that have been maltreated may experience manifold negative effects later in life. Two such sequelae are social anxiety and dissociation. Recent studies have noted their frequent co-occurrence, but no hypothesis has yet been offered explaining how they interact. College undergraduates (N = 198) completed the Child Trauma Questionnaire, Liebowitz Social Anxiety Scale, and Cambridge Depersonalization Scale. Social anxiety significantly predicted severity of dissociation, and self-reported childhood maltreatment (CM) significantly predicted both social anxiety and dissociation. Notably, emotional abuse was the only significant subtype of CM to predict social anxiety. Furthermore, CM moderated the relationship between social anxiety and dissociation, such that the presence of CM strengthened the predictive effect of social anxiety on dissociation. This study was the first to implicate CM as a mechanism in the social anxiety-dissociation relationship. This study was also the first to note a social anxiety-dissociation link in a non-clinical sample, thus demonstrating the existence of this relationship along a continuum of severity - not solely for those with extreme disturbances.

Background: It remains unclear whether specific clinical factors contribute to heterogeneity in the timing of the onset of nonfatal suicidal behavior. This knowledge could have important implications for suicide prevention., Methods: Using a nationally representative US adult sample, the second wave of the National Epidemiologic Survey on Alcohol and Related Conditions (2004-2005; n = 34,629), we compared the characteristics of 4 different suicide attempter groups: those who first attempted (1) before 18 years, (2) from 18 to 34 years, (3) from 35 to 49 years, and (4) at 50 years or older. Specifically, DSM-IV psychiatric disorders that occurred before the first suicide attempt, childhood maltreatment experiences, parental history of psychiatric disorders, and sociodemographic characteristics were examined., Results: Most first nonfatal suicide attempts (85.3%) occurred before age 35 years. Compared with suicide attempts occurring from 18 to 34 years, suicide attempts occurring before 18 years were more strongly associated with childhood maltreatment and less strongly linked to lifetime prior psychiatric disorders, whereas first suicide attempts occurring at 35 years and older were more strongly associated with a prior lifetime history of substance use disorders, including alcohol use disorder and nicotine dependence, and mood disorders, including mania/hypomania and dysthymic disorder between 35 and 49 years and major depressive episode at 50 years and older (all P < .05)., Conclusions: These results suggest age differences in risk factors for first nonfatal suicide attempt. Improving early detection and treatment of psychiatric disorders and preventing childhood maltreatment may have broad benefits to reduce the burden of suicidal behavior at all ages., (© Copyright 2020 Physicians Postgraduate Press, Inc.)

Aim: High-intensity binge drinking (HIBD), defined as two or more times the gender-specific binge threshold, is rapidly increasing in the USA; however, the underlying contributing factors are poorly understood. This study investigated the relationship of adverse childhood experiences (ACEs) and HIBD., Methods: Two independent, cross-sectional samples were analysed: (a) past 12-month drinkers in the National Epidemiological Survey on Alcohol and Related Conditions-III (NESARC-III; n = 25,552) and (b) the National Institute on Alcohol Abuse and Alcoholism (NIAAA) clinical sample (n = 1303). Multinomial logistic regressions were utilized to estimate adjusted odds ratios (AORs) of ACEs on HIBD. Mediation analysis was performed to examine the relationship between the past 12-month psychiatric disorders, ACEs, and HIBD., Results: In the NESARC-III sample, prevalence of ACEs increased across all binge levels with the highest prevalence in extreme HIBD; ACEs were associated with higher odds for HIBD (level II, odds ratio (OR) = 1.2-1.4; P = 0.03-0.001; level III, OR = 1.3-1.9; P < 0.001). Prevalence of DSM-5 diagnoses also increased across all binge levels. Substance use disorders (SUD), mood, personality and post-traumatic stress disorders (PTSD) conferred the highest odds with extreme HIBD (SUD: OR = 21.32; mood: 1.73; personality: 2.84; PTSD: 1.97; all Ps < 0.001). Mediation analyses showed that the association between ACEs and HIBD was fully mediated through SUD (proportion mediated: 70-90%) and partially through other psychiatric disorders (20-80%). In the NIAAA sample, ACEs were 2-5 times more prevalent in extreme HIBD with higher odds (ORs = 3-8, P < 0.001) compared with non-bingers., Conclusion: ACEs were associated with significantly increased odds of HIBD and the relationship may be mediated by psychiatric disorders., (© The Author(s) 2020. Medical Council on Alcohol and Oxford University Press. All rights reserved.)

There is an association between the experience of childhood maltreatment and opioid misuse in adults, especially for women. However, we know little about this association in pregnancy, and less about processes that could be the target of interventions to help women better parent their infants. We examined reflective functioning as a putative process. Reflective functioning is the ability to interpret one's own and others' behavior in terms of underlying mental states, e.g., emotions, motivations, and beliefs. We sampled 55 pregnant women who misused opioids and 38 women at high risk due to medical factors, e.g., heart disease. We assessed maltreatment with the Maltreatment and Abuse Chronology of Exposure (MACE; Teicher & Parigger, 2015), and reflective functioning with the Reflective Functioning Questionnaire (RFQ; Fonagy et al., 2016). Maltreatment variables included the sum of severity across all subtypes, number of subtypes experienced, and severity of sexual, physical, and emotional abuse, and of neglect. We created a categorical opioid user group variable: women who used opioids in pregnancy vs. high-risk medical comparisons. We found that women who used opioids in pregnancy had poorer reflective functioning than did high-risk medical comparisons. We also created an opioid use severity scale (ranging from 0 to 3) from urine assays and history of prescribed opioids from medical records. Using Hayes (2012)'s bootstrapping PROCESS macro, we found that reflective functioning mediated the association between all maltreatment variables and opioid use severity. We discuss the results in terms of how best to intervene to improve women's reflective functioning, which may help their ability to parent., (Copyright © 2019 Elsevier Ltd. All rights reserved.)

Background: Often times, a child's disclosure is the only forensic evidence available in child abuse cases. Therefore, understanding disclosure patterns of suspected child abuse victims plays a critical role in the forensic investigations of both child physical abuse (CPA) and child sexual abuse (CSA) cases., Objective: To explore adults' retrospective reports about childhood disclosure of CPA and CSA., Participants and Setting: College students (N = 907) were screened for reported histories of CSA (n = 94) or CPA (n = 109)., Methods: Through an online survey, participants provided anonymous information regarding CSA and CPA experiences along with information about any disclosure events or opportunities that they have encountered since the abuse., Results: Among the adults reporting CSA histories, 50 % indicated disclosing the abuse during childhood; 80 % indicated any lifetime disclosure. Among the adults indicating CPA histories, 32 % reportedly disclosed the abuse to someone during childhood with 52 % reporting any lifetime disclosure. For both groups, length of delay until disclosure was bimodal with many individuals reporting immediately and many waiting considerable time. Among adults reporting CSA, a minority (16 %) indicated the abuse came to the attention of authorities, with even fewer CPA cases (8%) reporting authorities were aware of their abuse. Denial and recantation in a formal setting was infrequent regardless of abuse type reported., Conclusions: Given that participants experiencing CSA and CPA both reported low levels of denial and recantation, forensic investigators and practitioners may benefit from considering consistent interviewing approaches and protocols, regardless of the type of abuse suspected., (Copyright © 2019 Elsevier Ltd. All rights reserved.)

Punitive attitudes and consequences (e.g., incarceration) for prenatal illicit drug use persist in the United States despite evidence that these policies are ineffective and even harmful to women and children. For instance, the threat of these consequences can deter women from seeking healthcare, prenatal care, and drug treatment. Punitive responses may persist due to pejorative public perceptions of pregnant women who use illicit drugs. Although there is evidence that contextual information about prenatal drug use (e.g., drug type) can change such perceptions, other contextual influences are unknown. This experimental study tested whether receiving contextual information about a pregnant woman who uses drugs (specifically, her childhood trauma history) reduces punitive and increases supportive attitudes toward the woman. In a vignette-based 2( pregnancy status : pregnant/not pregnant) x 2( history of childhood trauma : interpersonal/non-interpersonal) between-subjects design, young adult university participants ( N = 461) were randomly assigned to read a vignette about a woman who uses methamphetamine. Punitive attitudes were significantly reduced by information that the pregnant woman had a history of childhood trauma, especially interpersonal (versus non-interpersonal) trauma ( η p 2  = .115). Supportive attitudes were not impacted ( η p 2  = .005). Information about the pregnant woman's trauma history predicted less agreement with incarcerating her, only indirectly, through less punitive attitudes ( R 2  = .21). Reductions in punitive attitudes were on the order of 1.5-2 points on 5-point self-report scales and controlled for participant gender and political conservatism. Results have practical implications for interdisciplinary work aimed at unlocking greater support for policies that help pregnant women make safe, informed decisions with dignity and access to healthcare.

Background: Neglect is the most common form of child maltreatment with consequences that appear to be as serious as for abuse. Despite this, the problem has received less than its due attention., Objective: To examine the relationship between the timing and chronicity of neglect during childhood and substance use in early adulthood., Participants and Setting: The sample consisted of a subset of 475 participants from the prospective Longitudinal Studies of Child Abuse and Neglect (LONGSCAN) consortium from five geographic areas around the U.S., Method: Neglect was assessed using abstracted information from CPS reports (birth-18) and self-reports of neglect (12-18). Participants completed a follow-up online survey (mean age of 24 years) that probed their use of substances., Results: The prevalence of substance use during the past year was comparable in this high-risk sample to the general population. Latent class analysis supported the presence of three groups related to the presence and timing of neglect: Chronic Neglect, Late Neglect and Limited Neglect. Late Neglect was the pattern most strongly linked to substance use in early adulthood., Conclusions: High-risk youth experiencing neglect beginning in mid- adolescence are especially vulnerable to later substance use. Those working with such youth and their families can play a valuable role helping ensure their basic needs are adequately met, and recognizing early signs of substance use and abuse., (Copyright © 2019 Elsevier Ltd. All rights reserved.)

Cancer is the leading cause of death among American Indian and Alaska Native (AIAN) women, and depressive symptoms have been linked to higher mortality, but research on depressive symptoms among AIAN cancer patients has been scant. The purpose of this exploratory study was, using the Framework of Historical Oppression, Resilience, and Transcendence, to examine risk and protective factors related to depressive symptoms in American Indian (AI) women cancer survivors. We examined the relationships of adverse childhood experiences (ACE), perceived health status, resilience, and social support with depressive symptoms in Northern Plains AI women cancer survivors. We used a cross-sectional design with purposive sampling of 73 female cancer survivors (aged 18 years or older) between June 2014 and February 2015. Hierarchical multiple regression was used to test three sets of variables in relation to depressive symptoms: (1) sociodemographics, (2) risk factors (ACE and perceived health), and (3) protective factors (psychological resilience and social support). Approximately 47 percent of participants had probable depressive symptoms. Depressive symptoms were inversely associated with perceived health, psychological resilience, and social support. These results support bolstering existing social support among AI cancer patients and survivors as well as prevention and intervention efforts that strengthen resilience.

Purpose: Trauma has been associated with risky sexual behavior in diverse populations. However, little is known about this association among men and women veterans. This study hypothesized that 1) a history of trauma would be associated with risky sexual behavior among men and women veterans, 2) interpersonal trauma would predict risky sexual behavior among women, whereas noninterpersonal trauma would predict risky sexual behavior among men, and 3) military-related trauma would constitute additional risk. Using data from 567 women and 524 men veterans enrolled at the Veterans Health Administration, this study investigated the association between trauma-related experiences and risky sexual behavior in the last 12 months. Risk and protective factors that have been frequently associated with sexual behavior in previous research were also included in the model., Methods: This study was drawn from the Women Veterans Cohort Study, a national survey of veterans. Bivariate and multivariate analyses were performed after multiple imputation for missing data., Results: Predictive factors associated with risky sexual behavior differed between men and women veterans. Among women, childhood sexual victimization and intimate partner violence were associated with risky sexual behavior. Among men, binge drinking was the single significant risk factor. Military exposures were not significantly associated with risky sexual behavior in either men or women., Conclusions: This study lays the groundwork for theory-generating research into the psychological underpinnings of noted associations and underscores the importance of integrated health services to address the range of issues affecting sexual behavior and related health outcomes., (Published by Elsevier Inc.)

Background: Understanding the association of polydrug use disorders (PUD) with psychosocial and clinical factors is essential for the treatment of individuals with opioid use disorder (OUD). The aim of this study is to examine whether there is an association between childhood maltreatment, mood disorders, anxiety disorders, personality disorders, or posttraumatic stress disorder (PTSD) and PUD in individuals with OUD., Methods: We used data from 356 individuals with OUD in the past 12 months from a nationally representative database in the United States. PUD patients were classified into two groups: a group with additional one substance disorder (OUD + 1) and that with two or more additional substance disorders (OUD + 2). We conducted multivariate logistic regression to predict the PUD status, after adjustment for confounders including childhood maltreatment., Results: Among all individuals, 57.3% were polydrug users (n = 204) and 42.7% were not (n = 152). There was a high prevalence of childhood maltreatment in both groups, ranging from 16.1% to 59.5%, but the difference was not statistically significant. After adjustment for confounders, we found an association between past-year PTSD and OUD + 2 (odds ratio: 3.98; 95% confidence interval: 1.15-13.72; p = 0.03) but not with OUD + 1., Conclusion: PTSD is highly prevalent in individuals with OUD using multiple substances and could influence PUD. We recommend screening for PTSD in cases of PUD. Future studies should evaluate the effect of PTSD treatment on PUD., (Copyright © 2019 Elsevier B.V. All rights reserved.)

This research used a descriptive qualitative approach to explore coping with childhood sexual abuse (CSA) and to identify long-term psychological outcomes among Arab American women. Ten Arab American women participated in the study. Data were collected by individual semi-structured interviews and analyzed using content analysis. Five categories emerged for CSA experience among the participants: CSA characteristics, social support, Arabic culture, coping, and long-term psychological outcomes. Most of the women had experienced familial and contact CSA . and had disclosed their CSA and received different reactions from family and friends. Arabic cultural values influenced the women's experience of CSA and their coping strategy, especially regarding the CSA disclosure and seeking mental health services. The women used a spectrum of strategies to cope with their abuse including seeking support, positive reappraisal,,, accepting responsibilities, avoidance and protective coping. All women experienced negative long-term psychological outcomes of CSA such as flashbacks and low self-esteem. Prior to this research, no known studies have explored coping with CSA experience among Arab American women. Thus, this study can be used to inform practice guidelines to minimize the stigma of CSA and to promote help-seeking behavior for Arab American female CSA survivors and their families.

Childhood polyvictimization is related to a heightened risk for mental health and functional problems in young adulthood, including posttraumatic stress symptoms, but little research has examined how perceptions of the prevalence of victimization may contribute to specific symptoms of posttraumatic stress. The primary aims of the current study were to (a) evaluate the accuracy of young adults' beliefs about the prevalence of multiple types of childhood victimization and (b) determine how inaccurate appraisals of victimization prevalence are associated with posttraumatic stress symptoms. College students ( n = 369) drawn from two geographic regions of the United States responded to an online survey assessing their experiences of childhood victimization, perceptions about the prevalence of victimization, emotion regulation skills, and mental health. Childhood polyvictimization was significantly and positively related to distorted appraisals of the prevalence of victimization overall ( r = .26, p < .001), and emotion regulation was associated with symptoms of posttraumatic stress in all domains. Distorted perceptions of the prevalence of victimization were linked to higher symptoms of hyperarousal, but not to higher symptoms of reexperiencing, avoidance, or negative mood/cognition. Results suggest that emotion regulation skills training is likely to be beneficial for many individuals experiencing posttraumatic stress, and intervention around perceptions of the prevalence of victimization may be useful for addressing symptoms of hyperarousal., (© Copyright 2019 Springer Publishing Company, LLC.)

Individuals with severe psychiatric disabilities face many challenges from their experience of mental health problems, but also from disenfranchisement, marginalization, and stigmatization from a sociocultural experience. Those who are sexual trauma survivors also have unique challenges and intersecting experiences, which are not historically well understood, acknowledged, or treated in U.S. systems of care. Both in historic and modern mental health systems there have been methods thought of as interventions that have been or are currently reported as traumatizing to those who experience them. This article highlights the specific challenges, needs, and organizational shifts that U.S. systems of care need to be aware of and embark upon in order to provide treatment that is more efficacious with and cognizant of the experiences of those who are sexual trauma survivors. Furthermore, new paradigms for providing mental health treatment are offered in the context of providing trauma-informed as well as trauma treatment to those who are sexual trauma survivors and experience severe psychiatric disabilities.

History of childhood sexual assault (CSA) may result in poorer emotion regulation and interpersonal functioning, potentially affecting the tolerability and effectiveness of evidence-based treatments (EBTs) for posttraumatic stress disorder (PTSD). Survivors of military sexual trauma (MST) have an increased incidence of CSA; however, research examining the role of CSA in EBTs for veterans with MST-related PTSD is limited. Data from 32 (9 male; 23 female) veterans with MST-related PTSD were used from a previously conducted randomized clinical trial examining the efficacy of an outpatient PTSD EBT (i.e., cognitive processing therapy [CPT]). Self-rated PTSD symptom severity was assessed at pretreatment, during treatment, and up to 6 months following treatment completion. Number of CPT sessions attended and treatment completion were also examined. Using a hierarchical linear modelling approach, results indicated both veterans with and without a history of CSA were found to benefit from CPT, and history of CSA did not significantly predict treatment response. Additionally, number of sessions attended and treatment completion did not significantly vary based on history of CSA. These preliminary findings provide support for the tolerability and efficacy of outpatient CPT in veterans with MST-related PTSD regardless of CSA history., (Published 2018. This article is a U.S. Government work and is in the public domain in the USA.)

Background: Suicide is a leading cause of death among adolescents and young adults. The current study extends the research linking adverse childhood experiences (ACEs) to suicidal behaviors by testing these associations using a nationally representative sample, assessing for suicide ideation and attempts in adulthood, controlling for established risk factors for suicidality, and measuring a broad array of ACEs., Methods: The sample included 9,421 participants from the National Longitudinal Study of Adolescent Health who participated in four waves of assessments spanning 13 years. We examined longitudinal associations between eight different ACEs (physical, sexual, and emotional abuse, neglect, parental death, incarceration, alcoholism, and family suicidality) with suicidal ideation and suicide attempts in adulthood, while controlling for depression, problem alcohol use, drug use, delinquency, impulsivity, gender, race, age, and urbanicity. We also tested for cumulative associations of ACEs with suicide ideation and attempts., Results: Logistic regression analyses indicated that physical, sexual, and emotional abuse, parental incarceration, and family history of suicidality each increased the risk by 1.4 to 2.7 times for suicidal ideation and suicide attempts in adulthood. The accumulation of ACEs increased the odds of suicide ideation and attempts. Compared with those with no ACEs, the odds of seriously considering suicide or attempting suicide in adulthood increased more than threefold among those with three or more ACEs., Conclusions: Intervention strategies need to prevent ACEs from occurring and, if they do occur, should take into account the impact of cumulative ACEs on suicide risk. Future research should focus on identifying mediating mechanisms for the ACEs-suicidality association using longitudinal research designs and determine which ACEs are most important to include in a cumulative ACE measure., (© 2018 John Wiley & Sons Ltd.)

Background: Long term negative physical and mental health problems occur from the lack of appropriate interventions targeting the adult population who experienced adverse childhood experiences (ACEs) and partake in risky alcohol consumption behaviors., Objective: This study aimed to identify the risk for alcohol consumption behaviors, specifically binge drinking (BD) and any drinking (AD), among adults with a history of adverse childhood experiences (ACEs)., Methods: Behavioral Risk Factor Surveillance System (BRFSS) 2011-2012 data were used. Descriptive statistics were completed followed by simple and multiple logistic regression to determine the strength of association between ACEs and alcohol consumption, controlling for sociodemographic factors., Results: The final adjusted sample size was 69,793. Adults who experienced household abuse were 30% more likely to BD (Odds Ratio (OR): 1.30, 95% Confidence Interval (CI): 1.20-1.41) and 21% more likely for AD (OR: 1.21, 95% CI: 1.14-1.28) in the past month. Males were over two times more likely to BD (OR: 2.12, 95% CI: 1.96-2.29) and 60% more likely for AD (OR: 1.60, 95% CI: 1.51-1.69) in the past month compared to females. Individuals who completed some college were at higher risk of BD (OR: 1.51, 95% CI: 1.26-1.82), whereas those who graduated college were nearly two and a half times more likely to report AD in the past month (OR: 2.27, 95% CI: 1.99-2.59) compared to individuals with less than high school education., Conclusion: Adults who experienced household abuse, are male, or possess at least some college education are at increased risk for BD and AD., (Copyright © 2018 Elsevier Ltd. All rights reserved.)

This study examines the effect of a history of childhood maltreatment (CM) on parenting sense of competence, taking into account the influence of resilience and postpartum depressive symptoms as moderators of this relationship. Participants (N = 131) were a community sample of women recruited into a larger study of maternal childhood maltreatment. Women completed questionnaires over the phone at 4 months postpartum and parenting sense of competence (PSOC) was assessed during a home visit at 6 months postpartum. A three-way interaction emerged; women with low depression and high resilience factors maintained high levels of PSOC, even when they had a CM history. In contrast, among women with one postpartum risk factor (depression or low resilience) CM was associated with decreased PSOC. Results suggest that a mother's well-being postpartum moderates the effect of a childhood maltreatment history on her parenting sense of competence. Reducing postpartum depressive symptoms and enhancing resilience may be important components for interventions that address parenting confidence with maltreated women.

Introduction: While the BDNF Val66Met polymorphism has been linked to various psychological disorders, limited focus has been on its relationship to posttraumatic stress disorder (PTSD) and early traumas such as child abuse. Therefore, we assessed whether Val66Met was associated with fear potentiated psychophysiological response and HPA axis dysfunction and whether PTSD status or child abuse history moderated these outcomes in a sample of Veterans., Methods: 226 and 173 participants engaged in a fear potentiated acoustic startle paradigm and a dexamethasone suppression test (DST) respectively. Fear conditions included no, ambiguous, and high threat conditions. Psychophysiological response measures included electromyogram (EMG), skin conductance response (SCR), and heart rate. The Clinician Administered PTSD Scale (CAPS) and the Trauma History Questionnaire (THQ) were used to assess PTSD status and child abuse history respectively., Results: Met allele carriers exhibited greater SCR magnitudes in the no and ambiguous threat conditions (p < 0.01 and p < 0.05 respectively). Met carriers with PTSD exhibited greater physiological response magnitudes in the ambiguous (SCR, p < 0.001) and high threat conditions (SCR and heart rate, both p ≤ 0.005). Met carrier survivors of child abuse exhibited blunted heart rate magnitudes in the high threat condition (p < 0.01). Met allele carries with PTSD also exhibited greater percent cortisol suppression (p < 0.005)., Limitations: Limitations included small sample size and the cross-sectional nature of the data., Conclusions: The Val66met may impact PTSD susceptibility differentially via enhanced threat sensitivity and HPA axis dysregulation. Child abuse may moderate Val66Met's impact on threat reactivity. Future research should explore how neuronal mechanisms might mediate this risk., (Published by Elsevier B.V.)

Childhood adversity (CA) has life-long effects that we are just beginning to understand. The Midlife in the United States (MIDUS) data is a rich resource that could contribute to the knowledge of the impact of CA in the later years but, while a number of CA items are included in MIDUS, a cumulative CA scale based on those items has not been created. Development of a CA scale would create numerous research opportunities within MIDUS and overcome some of the challenges of using a secondary dataset. The present study aimed to demonstrate that a cumulative measure of CA that is valid with older adults could be created using retrospective MIDUS Refresher study data (Ryff et al., 2016); analysis included data collected from 2011 to 2014 from 2542 adults ages 23-76 (1017 adults 55-76). The present study provided a rationale for which measures of CA to include in a cumulative scale. The distribution of eight types of CA and the cumulative CA scale were consistent with findings from past studies of CA. The factor structure of the cumulative CA scale was similar to the original ACE study and included two factors: household dynamics and child abuse/neglect. Consistent with past studies, the CA scale predicted a negative association with life satisfaction and a positive association with number of chronic conditions. This study demonstrated that an effective cumulative measure of CA could be created that would be of value to other studies using MIDUS data to explore outcomes with older adults., (Copyright © 2018 Elsevier Ltd. All rights reserved.)

Domestic minor sex trafficking (DMST) is the recruitment, harboring, transportation, provision, or obtaining of U.S. minors for the purposes of a commercial sex act. DMST victims and survivors often become involved with state-level systems including the child welfare and/or juvenile justice systems. This study presents exploratory qualitative findings regarding the role of interpersonal relationships in the lives of system-involved DMST survivors from the perspectives of DMST survivors. Results indicate survivors perceive interpersonal relationships as key to promoting risk, providing protection, and fostering resiliency over DMST. Findings from the current study not only provide a context for understanding the role of interpersonal relationships in the lives of DMST survivors but also point to directions for development of interventions targeted toward this population., (Copyright © 2018 Elsevier Ltd. All rights reserved.)

Research on factors associated with good mental health following child maltreatment is often based on unrepresentative adult samples. To address these limitations, the current study investigated the relationship between individual-level factors and overall mental health status among adolescents with and without a history of maltreatment in a representative sample. The objectives of the present study were to: 1) compute the prevalence of mental health indicators by child maltreatment types, 2) estimate the prevalence of overall good, moderate, and poor mental health by child maltreatment types; and 3) examine the relationship between individual-level factors and overall mental health status of adolescents with and without a history of maltreatment. Data were from the National Comorbidity Survey of Adolescents (NCS-A; n = 10,123; data collection 2001-2004); a large, cross-sectional, nationally representative sample of adolescents aged 13-17 years from the United States. All types of child maltreatment were significantly associated with increased odds of having poor mental health (adjusted odds ratios ranged from 3.2 to 9.5). The individual-level factors significantly associated with increased odds of good mental health status included: being physically active in the winter; utilizing positive coping strategies; having positive self-esteem; and internal locus of control (adjusted odds ratios ranged from 1.7 to 38.2). Interventions targeted to adolescents with a history of child maltreatment may want to test for the efficacy of the factors identified above., (Copyright © 2018 The Author(s). Published by Elsevier Ltd.. All rights reserved.)

Sexual assault is a troubling epidemic that plagues college campuses across the United States, and is often proceeded by drinking by the perpetrator and/or victim. The goal of this study was to examine the effect of level of intoxication, history of alcohol-related blackouts, and childhood sexual abuse (CSA) on the likelihood of being a victim or perpetrator of coercive sexual activities. Participants (N = 2,244) were part of a 6-year longitudinal study which explored alcohol use and associated behavioral risks during college. A subsample (N = 1,423) completed 30 days of daily diary surveys across four years of college. Participants provided daily reports of their alcohol consumption, sexual coercion perpetration, and sexual coercion victimization. Using hierarchical linear models, results indicated that increases in daily estimated blood alcohol concentration (eBAC) were associated with a greater likelihood of being a victim and a perpetrator of sexual coercion. In addition, main effects of CSA and history of blackouts predicted a greater likelihood of being coerced into sexual activity, but blackouts were not associated with being a perpetrator. A significant interaction between blackouts and event-level eBAC indicated that individuals with a history of blackouts had a greater likelihood of sexual coercion victimization relative to those without prior blackouts. Finally, having a history of blackouts and CSA was predictive of a lower likelihood of being a perpetrator of sexual coercion at higher eBACs relative to those without a history of blackouts. Thus, prevention efforts should integrate the impact of blackouts and CSA on sexual coercion victimization and perpetration. (PsycINFO Database Record, ((c) 2018 APA, all rights reserved).)

Objective: Understanding suicide risk is a priority for the US military. We aimed to estimate associations of childhood maltreatment with pre-enlistment suicidal behaviors in new Army soldiers., Methods: Cross-sectional survey data from 38,237 soldiers reporting for basic training from April 2011 through November 2012 were analyzed. Scales assessing retrospectively reported childhood abuse and neglect were derived and subjected to latent class analysis, which yielded 5 profiles: No Maltreatment, Episodic Emotional Maltreatment, Frequent Emotional/Physical Maltreatment, Episodic Emotional/Sexual Abuse, and Frequent Emotional/Physical/Sexual Maltreatment. Discrete-time survival analysis was used to estimate associations of maltreatment profiles with suicidal behaviors (assessed with a modified Columbia-Suicide Severity Rating Scale), adjusting for sociodemographics and mental disorders., Results: Nearly 1 in 5 new soldiers was classified as experiencing childhood maltreatment. Relative to No Maltreatment, all multivariate maltreatment profiles were associated (P values < .001) with elevated odds of lifetime suicidal ideation (adjusted odds ratios [AORs] = 3.10-4.93), plan (AORs = 3.75-10.77), attempt (AORs = 3.60-15.95), and onset of plan among those with ideation (AORs = 1.40-3.10). Several profiles also predicted attempts among those with plans (AORs = 2.01-2.47), and Frequent Emotional/Physical/Sexual Maltreatment predicted unplanned attempts among ideators (AOR = 5.32). Adjustment for mental disorders attenuated but did not eliminate these associations., Conclusions: Childhood maltreatment is strongly associated with suicidal behavior among new soldiers, even after adjusting for intervening mental disorders. Among soldiers with lifetime ideation, certain maltreatment profiles are associated with elevated odds of subsequently planning and/or attempting suicide. Focus on childhood maltreatment might reveal avenues for risk reduction among new soldiers., (© Copyright 2018 Physicians Postgraduate Press, Inc.)

The South Asian community is the fastest growing ethnic group in the United States, and past research suggests that South Asian domestic violence (DV) survivors may require culturally-specific resources. Similarly, South Asian children in the US exposed to DV may have unique responses and needs, but this has not been explored to date. The objective of this study was to examine the specific needs of South Asian children exposed to DV from the vantage point of staff from South Asian DV agencies across the United States. Thirty interviews were conducted, with data coded and consolidated into larger themes using thematic analysis. Participants described several factors important to understanding the impact of DV on South Asian children including the role of the extended family, identifying with two cultures, fear about what the South Asian community will think, gender differences, and the importance of projecting an image of perfection. Participants also discussed development of culturally-tailored resources. This study suggests the importance of framing South Asian children's experiences within the context of interweaving South Asian and American cultural values, with careful attention paid to how potential culture clashes between parents and children may impact the way children process trauma. Further work should triangulate these themes with children, parents, and extended family, as well as collaborate with South Asian DV agencies to design child-focused programs., (Copyright © 2017 Elsevier Ltd. All rights reserved.)

Limited attention has been directed at adult children with a history of parental incarceration. The goal of the current study is to expand our understanding of the gendered effects of imprisonment on the adult offspring of incarcerated parents through the exploration of violence perpetration among a sample of young adults. Congruent with problem behavior theory, it is hypothesized that young adults who have been affected by parental incarceration will report greater aversive outcomes (i.e., more risk factors and violence perpetration) than their peers without a history of parental incarceration. Furthermore, it is hypothesized that parental incarceration predicts violent perpetration even after controlling for individual and familial risk factors and demographic characteristics. A series of bivariate and multivariate statistical models utilizing self-report data from 534 college students were generated to test said hypotheses. In addition, the moderating effects of students' sex and exposure to parental incarceration on the relationship between violence perpetration and risk factors were explored through the utilization of split logistic regression models. Roughly 1 in 10 (13.3%) students surveyed had experienced parental incarceration. As expected, students affected by parental incarceration were significantly more likely to perpetrate violence than their peers not affected by parental incarceration, net individual and familial risk. Although only a small percentage of students had experienced the imprisonment of a parent, parental incarceration predicted violence perpetration in young adulthood. These findings highlight the need to explore the long-lasting effects of parental incarceration on prisoners' offspring across the life course.

Betrayal trauma theory proposes a relation between intimate partner violence (IPV) and dissociation, suggesting that dissociation among victims of IPV may function to restrict awareness of abuse in order to preserve attachments perceived as vital. We investigated two factors that may moderate the relation between IPV and dissociation-childhood sexual abuse (CSA) severity and fear of abandonment-among 348 women currently in a relationship. The relation between frequency of IPV (sexual and physical) and dissociation (amnesia and depersonalization) was moderated by CSA severity and fear of abandonment. Specifically, among women with clinically relevant fear of abandonment, the strength of the relation between IPV and dissociation became stronger as CSA severity increased. This study is the first to demonstrate the moderating roles of fear of abandonment and CSA history in the relation between IPV and dissociation among women. Findings suggest that it may be important to target fear of abandonment in interventions with IPV victims who have a CSA history. Results suggest that fear of abandonment warrants greater attention in research on IPV revictimization.

While striving to succeed in the face of adversity may provide individuals with outward benefits, it may come at a cost to individuals' physical health. The current study examines whether striving predicts greater physiological or psychosocial costs among those who experienced child maltreatment, a stressor that disrupts the caregiving environment and threatens relationship security. Using data from the National Longitudinal Study of Adolescent to Adult Health, we tested whether greater striving after childhood maltreatment would come at a cost, increasing underlying cardiovascular disease (CVD) risk and depressive symptoms despite showing outward success via income and college degree attainment. The study included 13,341 Black, Hispanic, and White adolescents who self-reported striving and their experiences of childhood neglect, physical abuse, and sexual abuse. As young adults, participants reported depressive symptoms, income, and college degree attainment and completed a health assessment from which a 30-year Framingham-based CVD risk score was calculated. Higher striving was associated with lower CVD risk and depressive symptoms, and higher income and college degree attainment, regardless of maltreatment history. These findings highlight the potential for striving as a target for interventions and support the need to examine multiple biological and behavioral outcomes to understand the multifaceted nature of resilience.

Hispanics experience health disparities in mental health and HIV infection when compared to non-Hispanic Whites, which may be related to childhood abuse. The purpose of our cross-sectional study was to examine the relationship between childhood abuse and depressive symptoms in a sample of Hispanic men (N = 103) living in a metropolitan U.S.-Mexico border area. Secondarily, we examined the role of self-esteem in mediating this relationship, and the moderating role of sexual orientation. Gay/bisexual men (n = 53) were more likely to report childhood abuse than heterosexual (n = 50) counterparts (47.2% vs. 32%). Self-esteem mediated the relationship between childhood abuse and depression for men who have sex with men, but not heterosexual men. Nurses should increase knowledge of mental health disparities that impact Hispanic men to ensure that appropriate treatment can be provided to reduce the risk of co-occurring health risks to these men, including risk for HIV infection., (Copyright © 2017 Association of Nurses in AIDS Care. Published by Elsevier Inc. All rights reserved.)

Responses from N=60,598 interviews from the 2010 Behavioral Risk Factor Surveillance System (the 10 states and the District of Columbia that included the optional Adverse Childhood Experience (ACE) module) were used to test whether associations between childhood adversity and adult mental health and alcohol behaviors vary by race/ethnicity and sex. ACE items were categorized into two types - household challenges and child abuse. Outcomes were current depression, diagnosed depression, heavy drinking and binge drinking. Logistic regression models found ACEs significantly associated with depression and excessive alcohol use, but sex did not moderate any relationships. Race/ethnicity moderated the relationship between ACEs and heavy drinking. In stratified analyses, compared to those not exposed to ACEs, non-Hispanic blacks who experienced either type of ACE were about 3 times as likely to drink heavily; Non-Hispanic whites who experienced child abuse or both ACE types were 1.5-2 times as likely to drink heavily; and Hispanics who experienced household challenges or both ACE types were 1.2 and 11 times as likely to report heavy drinking. ACEs impact depression and excessive alcohol use similarly across men and women. With the exception of heavy drinking, ACEs appear to have the same association with excessive alcohol use across race/ethnicity. It may be prudent to further investigate why the relationship between ACEs and heavy drinking may differ by race/ethnicity such that prevention strategies can be developed or refined to effectively address the needs of all sub-groups., (Published by Elsevier Ltd.)