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The present study investigates how parenting stress mediates the intergenerational continuity of childhood adversity in teenage mothers. Childhood adversity experiences of caregivers significantly affect their offspring's exposure to childhood adversity. However, little is known about the mechanisms linking childhood adversity across generations. The study measures how parental distress and parent-child dysfunctional interaction mediate the association between teen mothers' childhood adversity and their offspring's adversity, measuring when the offspring reached 11.5 years of age. The results revealed that parental distress, but not parent-child dysfunctional interaction, mediated the association between teen mothers' child abuse and their offspring's household dysfunction. This suggests that parental distress may be a crucial intervention target to prevent the intergenerational continuity of childhood adversity. The findings imply that efforts to prevent the intergenerational continuity of childhood adversity may be more successful if the public and professionals have a broader understanding of the associations between early adversity and parenting contexts. In conclusion, the study shed light on the potential mechanisms underlying the intergenerational continuity of childhood adversity and highlights the importance of targeting parenting stress, specifically parental distress, as an intervention strategy to prevent the perpetuation of childhood adversity across generations. [ABSTRACT FROM AUTHOR]

Childhood adversity (CA) has a substantial correlation with mental health problems. Keeping a healthy lifestyle is essential for mental health interventions; it is unclear, however, how healthy lifestyle affect the relationship between CA and persistent mental health problems. This longitudinal study (n = 1112, 54.5 % male) collected the data on CA (measured through three dimensions: threat, deprivation and unpredictability), mental health problems, and lifestyle factors. Group-based multi-trajectory modeling (GBMTM) was utilized to estimate trajectories for three mental health problems (i.e., depression, ADHD and overanxiety). Close friendships, regular physical activity, appropriate sleep duration, shorter screen time, and healthy eating were combined to establish a healthy lifestyle score (which ranges from 0 to 5). Higher scores indicated a healthier lifestyle. Three trajectories of mental health problems were identified: persistently low risk (24.9 %), persistently medium-high risk (50.0 %), and persistently high risk (25.1 %). Multinomial logistic regression showed that high adversity (high-threat: β = 2.01, P < 0.001; high-deprivation: β = 1.03, P < 0.001; high-unpredictability: β = 0.83, P = 0.001; high-overall adversity: β = 1.64, P < 0.001) resulted in a persistently high risk of mental health problems; these outcomes were maintained after robust control for covariates. Further lifestyle stratification, null associations were observed among children with a healthy lifestyle, irrespective of their gender; however, after controlling for covariates, the above associations remained relatively stable only among boys. The generalizability of our findings is restricted by 1) limited racial diversity and 2) missing data. This finding underscores the benefits of promoting a healthy lifestyle in children to prevent persistent mental health problems caused by CA. • We identified three trajectories of multiple mental health problems in children. • Children exposed to high adversity are more likely to be at persistently high risk for mental problems. • A healthy lifestyle can help buffer the risk of a persistently high risk of mental health problems caused by adversity [ABSTRACT FROM AUTHOR]

Substance use among youth is associated with adverse consequences and may increase vulnerability to addiction and psychiatric disorders later in life. Sociocultural factors such as discrimination have been associated with substance use, while positive cultural resources, such as enculturation and familism, have demonstrated protective outcomes. However, few studies have highlighted how family factors influence substance use among Latinx youth during their transition from adolescence to young adulthood. This study used longitudinal data to explore the associations between sociocultural factors, family factors, childhood adversity, and substance use among Latinx youth. The data were from a longitudinal study of acculturation and substance use among Latinx youth in Southern California (n = 1257, 52.1% female, mixed socioeconomic status). The average age was 14.5 (SD = 0.39). Data collection began in 2005 and ended in 2016. Hierarchical regression models showed that discrimination was associated with higher problematic alcohol susceptibility. Childhood adversity was associated with higher odds of tobacco, alcohol, and marijuana use. Parental communication was associated with lower odds of problematic alcohol and marijuana use. To promote youth well‐being, preventive efforts should prioritize reducing childhood adversity and discrimination, while fostering positive family relationships. Overall, our findings suggest the need for interventions targeting various systemic levels to effectively address substance use among Latinx youth. [ABSTRACT FROM AUTHOR]

Few studies have addressed the influence of mass stressors in the context of couple relationships; therefore, understanding how unique constraints and stressors related to the COVID-19 pandemic influenced mental health distress and, in turn, loss in couple relationships is valuable. Because resource loss has been defined as the primary agent of stress, examining factors that may have shaped the degree of resource loss incurred during the pandemic will be vital. Previous research implies that early life adversity may be a form of resource loss and is linked to poorer mental health and relational outcomes in adulthood. Additionally, the stress sensitization hypothesis posits that childhood adversity may prime individuals to have a lower threshold for later life stress. As such, this study was designed to examine how family of origin stress (reported at the outset of pandemic related shutdowns in the US in April 2020) associated with posttraumatic stress (PTSS) 3 months later (July 2020) to, in turn, predict variation in resource losses associated with the COVID-19 pandemic reported 3 months later (October 2020) in 535 cisgender, heterosexual couples. Findings showed that individual's higher family of origin stress predicted higher levels of their own PTSS at wave 2, and higher PTSS at wave 2 predicted higher levels of couples' shared resource loss at wave 3. Additionally, family of origin stress is associated with higher levels of couples' shared experience of loss via higher levels of their own PTSS. [ABSTRACT FROM AUTHOR]

Major depressive disorder (MDD) is a debilitating mental illness, and it is considered to be one of the leading causes of disability globally. The etiology of MDD is multifactorial, involving an interplay between biological, psychological, and social factors. Early life represents a critical period for development. Exposure to adverse childhood experiences is a major contributor to the global burden of disease and disability, doubling the risk of developing MDD later in life. Evidence suggests that stressful events experienced during that timeframe play a major role in the emergence of MDD, leading to epigenetic modifications, which might, in turn, influence brain structure, function, and behavior. Neuroplasticity seems to be a primary pathogenetic mechanism of MDD, and, similarly to epigenetic mechanisms, it is particularly sensitive to stress in the early postnatal period. In this review, we will collect and discuss recent studies supporting the role of epigenetics and neuroplasticity in the pathogenesis of MDD, with a focus on early life stress (ELS). We believe that understanding the epigenetic mechanisms by which ELS affects neuroplasticity offers potential pathways for identifying novel therapeutic targets for MDD, ultimately aiming to improve treatment outcomes for this debilitating disorder. [ABSTRACT FROM AUTHOR]

Childhood adversity (CA), including childhood adverse life events, increases the risk for development of psychiatric disorders later in life. Both CA and psychiatric disorders are associated with structural brain changes and dysfunctional hypothalamic–pituitary–adrenal‐axis. However, many studies investigated single diagnostic and single regions of interest of the brain, and did not take stress reactivity into account. We investigated associations of CA and cortisol levels with gray matter volume and cortical thickness, in a whole‐brain manner. Primary analysis constituted of a transdiagnostic approach, followed by a moderation analysis to investigate the influence of diagnosis. Patients with stress‐related and/or neurodevelopmental disorders and matched healthy controls underwent an magnetic resonance imaging scan, next to assessing hair cortisol levels and CA/life events. CA was reported by 62–72% of the patients versus 33% of the controls. Primary transdiagnostic linear regression analyses revealed that CA was not associated with gray matter volume, while childhood life events were associated with lower right thalamic volume. Hair cortisol was not associated with any lobe volume. None of the associations were moderated by diagnosis. In conclusion, CA is a risk factor that needs to be taken into account when investigating psychiatric disorders. Yet the relationship with structural brain changes and stress reactivity is less clear than postulated on the basis of more seed‐based studies. [ABSTRACT FROM AUTHOR]

Adverse childhood experiences (ACEs) affect approximately half of all children worldwide. These experiences have been linked to increased pain sensitivity in adulthood and a higher likelihood of developing severe chronic pain. However, most studies have assessed the effects of ACEs retrospectively, long after they occurred, leaving room for other factors to influence the observed outcomes. We investigated, for the first time, the association between ACEs and concurrent pain perception among young children who live in a conflict zone and are consistently exposed to potentially traumatic experiences. Participants were 60 elementary school children (ages 8-11 years) living in conflict regions (n = 39) or nonconflict regions (n = 21). Posttraumatic stress symptom (PTSS) severity, traumatic exposure, pressure pain threshold (PPT), and mechanical detection threshold (MDT) were measured. Traumaexposed children had significantly lower PPT than did controls, but MDT was similar across groups. Pressure pain threshold correlated positively with proximity to the conflict zone and inversely with traumatic exposure magnitude and PTSS severity. In addition, PTSSs moderated the relationship between repeated traumatic exposure and PPT. Children with higher PTSS severity displayed pain hypersensitivity regardless of their traumatic exposure level, whereas in children with lower PTSS severity, greater traumatic exposure correlated with pain hypersensitivity. The results suggest that ACEs among children lead to concurrent pain hypersensitivity and distress and may put them at elevated risk of chronic pain early in life. In addition, our findings emphasize the need for identifying children with various PTSS levels to provide tailored interventions and mitigate the long-term negative effects of ACEs. [ABSTRACT FROM AUTHOR]

Childhood adversity is linked to psychological, behavioral, and physical health problems, including obesity and cardiometabolic disease. Epigenetic alterations are one pathway through which the effects of early life stress and adversity might persist into adulthood. Epigenetic mechanisms have also been proposed to explain why cardiometabolic health can vary greatly between individuals with similar Body Mass Index (BMIs). We evaluated two independent cross-sectional cohorts of adults without known medical illness, one of which explicitly recruited individuals with early life stress (ELS) and control participants (n = 195), and the other a general community sample (n = 477). In these cohorts, we examine associations between childhood adversity, epigenetic aging, and metabolic health. Childhood adversity was associated with increased GrimAge Acceleration (GAA) in both cohorts, both utilizing a dichotomous yes/no classification (both p < 0.01) as well as a continuous measure using the Childhood Trauma Questionnaire (CTQ) (both p < 0.05). Further investigation demonstrated that CTQ subscales for physical and sexual abuse (both p < 0.05) were associated with increased GAA in both cohorts, whereas physical and emotional neglect were not. In both cohorts, higher CTQ was also associated with higher BMI and increased insulin resistance (both p < 0.05). Finally, we demonstrate a moderating effect of BMI on the relationship between GAA and insulin resistance where GAA correlated with insulin resistance specifically at higher BMIs. These results, which were largely replicated between two independent cohorts, suggest that interactions between epigenetics, obesity, and metabolic health may be important mechanisms through which childhood adversity contributes to long-term physical and metabolic health effects. [ABSTRACT FROM AUTHOR]

Latino/a/Hispanic adversity and adaptation literature has focused on cultural, acculturative and immigration-related stressors. Cultural and social strengths, key Latino/a/Hispanic features, and their concurrence, remain qualitatively underexplored. To enhance intervention and prevention, research understanding experiences of Latino/a/Hispanic youth adaptation representing three generations is needed. Forty participants participated in semi-structured interviews detailing adversity, cultural strengths and support during their youth. Thematic analysis approach guided coding of transcripts. Three coders met regularly to discuss and resolve differences, identifying emergent themes. The sample included 24 females and 16 males (M age = 27.9) characterizing three generations (first n = 15; second n = 14; third+ n = 11). Three main themes emerged: (1) perceived adversity, described discrimination, and related adversities; (2) cultural adaptation, adjustment, and the shaping of bicultural identities; and (3) supportive and formative relationships buffering adversity. Themes illustrated adversity and cultural strengths within Latino/a/Hispanic protective relationships and contexts. Findings inform policies that support Latino/a/Hispanic youth and family engagement and intervention approaches. [ABSTRACT FROM AUTHOR]

Quality relationships among families and teachers in early care and education (ECE) hold promise to nurture resilience among children impacted by adversity. However, little is known about how adverse childhood experiences (ACEs) may affect the interactions between families and teachers. This study uses quantitative survey data from families (N = 235) and qualitative interview data from teachers (N = 13) to examine the link between children's adversity and family-teacher relationship quality (knowledge, attitudes, practices) in ECE. Quantitative results indicate that when a child has experienced more of the ACEs conventionally studied (e.g. maltreatment, parent substance abuse or mental illness), parents are more likely to perceive lower quality practices with teachers, but when a child has experienced more ACEs on an extended measure (e.g., bullying, discrimination), parents are more likely to perceive higher quality practices with teachers. Qualitative results indicate that teachers report challenges in relationships with families when children experience trauma or adversity, but that ACEs also can present an opportunity to strengthen family-teacher relationships. Findings can inform professional development for teachers focused on strategies to work with families facing adversity, as well as policies related to program standards (e.g., family engagement) and interventions to improve family-teacher relationships quality. [ABSTRACT FROM AUTHOR]

Background: Childhood adversity has been associated with alterations in threat-related information processing, including heightened perceptual sensitivity and attention bias towards threatening facial expressions, as well as hostile attributions of neutral faces, although there is a large degree of variability and inconsistency in reported findings. Methods: Here, we aimed to implicitly measure neural facial expression processing in 120 adolescents between 12 and 16 years old with and without exposure to childhood adversity. Participants were excluded if they had any major medical or neurological disorder or intellectual disability, were pregnant, used psychotropic medication or reported acute suicidality or an ongoing abusive situation. We combined fast periodic visual stimulation with electroencephalography in two separate paradigms to assess the neural sensitivity and responsivity towards neutral and expressive, i.e. happy and angry, faces. Linear mixed effects models were used to assess the impact of childhood adversity on facial expression processing. Results: Sixty-six girls, 53 boys and one adolescent who identified as 'other', between 12 and 16 years old (M = 13.93), participated in the current study. Of those, 64 participants were exposed to childhood adversity. In contrast to our hypotheses, adolescents exposed to adversity show lower expression-discrimination responses for angry faces presented in between neutral faces and higher expression-discrimination responses for happy faces presented in between neutral faces than unexposed controls. Moreover, adolescents exposed to adversity, but not unexposed controls, showed lower neural responsivity to both angry and neutral faces that were simultaneously presented. Conclusions: We therefore conclude that childhood adversity is associated with a hostile attribution of neutral faces, thereby reducing the dissimilarity between neutral and angry faces. This reduced threat-safety discrimination may increase risk for psychopathology in individuals exposed to childhood adversity. [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]

Background During the last decades, an abundance of studies has investigated childhood adversity in relation to psychosis. This systematic review critically examines the methodologies employed to investigate childhood adversity in psychosis over the past decade, including operational definitions, measurement tools and characteristics, and psychometric properties of instruments used in these studies. Study Design This systematic review followed the PRISMA guidelines (registration number CRD42022307096), and the search used the following electronic databases: PsychINFO, SCOPUS, Web of Science, African Index Medicus (AIM), LILACS, CINAHL, EMBASE, and MEDLINE. The search included variations and combinations of the terms targeting childhood adversity and psychosis. Study Results Out of 585 identified studies published between 2010 and 2023, 341 employed a validated instrument to investigate childhood adversity. Our findings show "childhood trauma" being the most frequently examined construct, followed by "child maltreatment" or "child abuse." The short version of the Childhood Trauma Questionnaire was the dominant instrument. Physical abuse, emotional abuse, and sexual abuse were most frequently investigated, and indeed the field appears generally to focus on child abuse and neglect over other adversities. Significant psychometric heterogeneity was observed in the selection and summarization of instrument items, with only 59% of studies documenting original psychometric validation and 22% reporting reliability in their datasets. Conclusion This review highlights substantial methodological heterogeneity in the field, pointing out biases in the research on childhood adversity and psychosis. These findings underline the need for standardized definitions and high-quality measurement tools to enhance the validity of future research in this area. [ABSTRACT FROM AUTHOR]

This analysis examined relationships between childhood adversities and the odds of suicide attempt(s) prior to age 17. Respondents (N = 2072) completed the survey through Amazon's Mechanical Turk crowdsourcing platform. The sample was represented disproportionately by young adult women who identified as Caucasian. The sample was differentiated into subsets with versus without suicide attempt(s) prior to age 17. Suicide attempt(s) in this sample (22.4%) varied in number (once, n = 200; 9.7%; twice, n = 114, 5.5%; multiple, n = 150, 7.2%). The odds of suicide attempt(s) prior to age 17 were significantly (p <.001) higher for respondents reporting childhood sexual abuse (OR = 5.0), physical abuse (OR = 4.9), emotional abuse (OR = 3.7), peer bullying (OR = 3.1), parental neglect (OR = 1.6), and maternal battering (OR = 2.15). All adversities but exposure to maternal battering accounted for unshared variance in suicide attempts prior to age 17. Adverse Childhood Experiences Questionnaire exposure counts were associated with child and adolescent suicide attempts. Suicide risk did not appear to increment progressively by additional exposures after two co-occurring stressors. The odds of early suicide attempt(s) were markedly higher in this sample among respondents who were exposed to one or more forms of childhood adversity. [ABSTRACT FROM AUTHOR]

Elevated inflammatory activity is one possible pathway through which exposure to childhood adversity engenders risk for physical and psychiatric illnesses. Limited research has investigated the compounding effects of childhood and adolescent stress exposure on changes in circulating levels of inflammatory biomarkers. This study assessed whether childhood adversity interacted with chronic or acute stress during adolescence to affect the temporal trajectories of five inflammatory biomarkers across at least three blood draws in a diverse sample of adolescents (N = 134; observations = 462). Using multilevel modeling, the interaction of childhood adversity, time, and within-person variance of acute stressors significantly predicted trajectories of higher interleukin-10 levels, controlling for demographics, medication use, and body mass index. Adolescents with high levels of childhood adversity who were exposed to a higher frequency of acute stressors compared to their own average rate of stress exposure consistently had higher levels of IL-10 as they got older, but those with average and below frequency of acute stressors had decreasing trajectories of log IL-10 as they matured. The results demonstrate how events early in life shape biological responses to the adolescent environment. This study also highlights the importance of developmental timing on the bodys enhanced reactivity to acute and sustained stressors following childhood adversity.

Abstract Background Childhood adversity has been associated with alterations in threat-related information processing, including heightened perceptual sensitivity and attention bias towards threatening facial expressions, as well as hostile attributions of neutral faces, although there is a large degree of variability and inconsistency in reported findings. Methods Here, we aimed to implicitly measure neural facial expression processing in 120 adolescents between 12 and 16 years old with and without exposure to childhood adversity. Participants were excluded if they had any major medical or neurological disorder or intellectual disability, were pregnant, used psychotropic medication or reported acute suicidality or an ongoing abusive situation. We combined fast periodic visual stimulation with electroencephalography in two separate paradigms to assess the neural sensitivity and responsivity towards neutral and expressive, i.e. happy and angry, faces. Linear mixed effects models were used to assess the impact of childhood adversity on facial expression processing. Results Sixty-six girls, 53 boys and one adolescent who identified as ‘other’, between 12 and 16 years old (M = 13.93), participated in the current study. Of those, 64 participants were exposed to childhood adversity. In contrast to our hypotheses, adolescents exposed to adversity show lower expression-discrimination responses for angry faces presented in between neutral faces and higher expression-discrimination responses for happy faces presented in between neutral faces than unexposed controls. Moreover, adolescents exposed to adversity, but not unexposed controls, showed lower neural responsivity to both angry and neutral faces that were simultaneously presented. Conclusions We therefore conclude that childhood adversity is associated with a hostile attribution of neutral faces, thereby reducing the dissimilarity between neutral and angry faces. This reduced threat-safety discrimination may increase risk for psychopathology in individuals exposed to childhood adversity.

Purpose: Previous research indicates that social support is protective for the mental health outcomes of exposure to childhood adversity. However, the impact of social support as a protective factor following exposure to cumulative childhood adversity is understudied with prospective longitudinal data. The aim of this present study was to examine how social support mediates the impact of cumulative exposure to childhood adversity on internalising disorder in adulthood. Methods: The Christchurch Health and Development Study (CHDS) is a general population birth cohort, born in 1977 and representative of Christchurch, New Zealand at the time of the cohort members' birth. The present study used a generalised estimating equations (GEE) framework to analyse direct associations between a cumulative measure of childhood adversity (CA) and internalising disorders (major depression, and any anxiety disorder), and indirect associations through social support. Results: Results indicated a dose-dependent relationship between increased exposure to CA and worsened odds of a diagnosis for major depression and any anxiety disorder, respectively. There was also a significant mediating effect of social support on the direct associations between CA and both major depression (OR (95%CI) =0.98 (0.97, 0.99), p < 001) and any anxiety disorder (OR (95%CI) =.98 (0.97, 0.99), p < 001). Conclusion: The findings indicate that social support reduces the impact of childhood adversity on adult mental health, and is therefore a target for future work examining potential interventions following CA. [ABSTRACT FROM AUTHOR]

Abstract Background Adverse childhood experiences (ACEs) have been implicated in the aetiology of a range of health outcomes, including multimorbidity. In this systematic review and meta-analysis, we aimed to identify, synthesise, and quantify the current evidence linking ACEs and multimorbidity. Methods We searched seven databases from inception to 20 July 2023: APA PsycNET, CINAHL Plus, Cochrane CENTRAL, Embase, MEDLINE, Scopus, and Web of Science. We selected studies investigating adverse events occurring during childhood (

Abstract Background Childhood adversities worsen physical and mental health across the lifespan. Health and social care practitioners play a key role in identifying and responding to childhood adversity, however, may be reluctant to do so due to a perceived lack of services to refer to, time pressures and a deficit of training and confidence. We aimed to (1) quantify changes in practitioner comfort and confidence to identify and respond to childhood adversity following a multimodal intervention within an integrated child and family health and social care hub and (2) to understand barriers and facilitators of practice change. Methods Hub practitioners were surveyed about their competence and comfort to directly ask about and confidence to respond to adversity at baseline and then at six and twelve months post training. Interviews were undertaken to explore practitioner barriers and enablers of practice change. Interviews were recorded, transcribed verbatim, and analysed using reflexive thematic analysis. The theoretical domains framework was used to identify the key drivers of practice change. Results Fifteen of 18 practitioners completed all three surveys and 70% reported increased competence and comfort to directly ask, and confidence to respond across a range of adversities over the 12-month intervention. Twenty-one practitioners completed interviews. Six themes were identified as either facilitators or barriers to practice change. Facilitator themes included (1) connection matters, (2) knowledge provides assurance, (3) confidence in ability and (4) choosing change. Barrier themes were (1) never enough time and (2) opening Pandora’s box. Following analysis, key drivers of practice change were ‘social influence’, ‘belief in capability’, ‘knowledge’ and ‘behaviour regulation’ while barriers to practice change were ‘environmental context and resources’ and ‘emotion’. Conclusions Practitioners reported improved confidence in identifying and responding to adversity through a multimodal intervention delivered in an integrated Child and Family Hub. Changing practice requires more than just education and training. Opportunities for social connection and coaching to improve self-confidence and perceived competence are needed to overcome the fear of opening Pandora’s box.

Abstract Background Adverse childhood experiences can impact physical and mental health throughout the lifespan. To support families experiencing adversity and improve child health and developmental equity, an integrated, multi-sector response is required. Child and Family Hubs (Hubs) are a feasible and acceptable approach to providing such a response. In the Australian context, a number of federal and New South Wales (NSW) state policies support an integrated, multi-sector response using Hubs to support families experiencing adversity. This study examined NSW policy stakeholder and health service manager perspectives on the barriers and enablers to translating policy into practice in the implementation of Child and Family Hubs. Methods Semi-structured interviews were conducted with 11 NSW government policy stakeholders and 13 community health service managers working in child and family policy and planning or child and family community-based services. Interviews were of 30–60 min duration and explored stakeholder knowledge, perspectives and experiences around childhood adversity, and barriers and enablers to operationalizing policies supporting Hubs. Analysis of barriers and facilitators to implementation of Hub models of care was undertaken using the Consolidated Framework for Implementation Research (CFIR). Results Key barriers that emerged included short-term and inconsistent funding, lack of resourcing for a Hub co-ordinator, limited support for evaluation and insufficient time to plan for Hub implementation. Key enablers included flexibility and adaptability of Hub models to meet local needs, formal change management processes, strong governance structures and engagement among Hub practitioners. Key insights included the importance of targeted strategies to support sustained individual practice change and the need for organization-wide commitment to enable the successful adoption and maintenance of the Hub model of care. Conclusions This study provides valuable insights and contributes evidence around what is needed to strengthen and support the operationalization and scalability of the Hub model of care. Key recommendations for Hub practitioners include the importance of formal change management processes and establishment of strong governance structures, while key recommendations for policymakers include the need for sustainable Hub funding and a standardized, evidence-based framework to support Hub implementation and evaluation.

Abstract Background Childhood adversities may lead to decreased activity participation in later life, impacting memory health in ageing adults. Childhood adversities related to deprivation and threat, as conceptualized by the Dimensional Model of Adversity, can exhibit distinct impacts on cognitive and emotional outcomes in children and younger adults. This study examined the potential influence of childhood deprivation and threat on memory function in later life and the mediating role of activity participation in these relationships. Methods This study used data from the first wave of Panel Study of Active Ageing and Society (PAAS), a representative survey of Hong Kong residents aged 50 or above (N = 1,005). Key variables included late-life memory function measured by delayed recall test, deprivation- and threat-related childhood adversities, and the frequency of participation in informal and formal types of activities. Mediation tests were used for analysis. Results Childhood deprivation was associated with a lower late-life memory function, whereas threat was not. The negative effects of childhood deprivation and its subdomain, economic hardship, on memory function were mediated by activity participation. Total participation scores presented the strongest mediating effect (17.3–20.6%), with formal activities playing a more substantial mediating role than informal activities in mitigating the effect of childhood deprivation. Conclusions These findings expand the applicability of the Dimensional Model of Adversity to ageing populations, highlighting the influence of deprivation on life-long cognitive development. Furthermore, this study revealed an indirect mechanism by which childhood deprivation affects memory health in old age through diverse activity participation.

Abstract Background The physical and psychological benefits of physical activity are well-known, and physical activity has been proven to be a helpful adjunct to psychotherapeutic treatment for many symptomatic disorders, including mood and anxiety disorders. The current study explores physical inactivity levels in patients with borderline personality disorder (BPD). The first aim of this study is to describe the 12-year course of physical inactivity in patients with BPD. The second aim is to examine predictors of physical inactivity, including adversity experiences, comorbid symptomatic (formerly axis I) disorders, medical disorders, and demographic factors. Methods Two hundred and forty-five patients with BPD were interviewed seven times over 12-years of prospective follow-up as part of the McLean Study of Adult Development (MSAD). Patients were categorized as ever-recovered (i.e., patient had experienced a symptomatic and psychosocial recovery from BPD) or never-recovered. At each follow-up, patients reported physical activity levels (minutes of exercise per week) via a semi-structured interview— the Medical History and Services Utilization Interview (MHSUI). Data was collected from June 1992 to December 2018. Results Never-recovered patients with BPD were significantly more inactive than their ever-recovered counterparts (p

Background: Adverse childhood experiences (ACEs) have been implicated in the aetiology of a range of health outcomes, including multimorbidity. In this systematic review and meta-analysis, we aimed to identify, synthesise, and quantify the current evidence linking ACEs and multimorbidity. Methods: We searched seven databases from inception to 20 July 2023: APA PsycNET, CINAHL Plus, Cochrane CENTRAL, Embase, MEDLINE, Scopus, and Web of Science. We selected studies investigating adverse events occurring during childhood (< 18 years) and an assessment of multimorbidity in adulthood (≥ 18 years). Studies that only assessed adverse events in adulthood or health outcomes in children were excluded. Risk of bias was assessed using the ROBINS-E tool. Meta-analysis of prevalence and dose–response meta-analysis methods were used for quantitative data synthesis. This review was pre-registered with PROSPERO (CRD42023389528). Results: From 15,586 records, 25 studies were eligible for inclusion (total participants = 372,162). The prevalence of exposure to ≥ 1 ACEs was 48.1% (95% CI 33.4 to 63.1%). The prevalence of multimorbidity was 34.5% (95% CI 23.4 to 47.5%). Eight studies provided sufficient data for dose–response meta-analysis (total participants = 197,981). There was a significant dose-dependent relationship between ACE exposure and multimorbidity (p < 0.001), with every additional ACE exposure contributing to a 12.9% (95% CI 7.9 to 17.9%) increase in the odds for multimorbidity. However, there was heterogeneity among the included studies (I2 = 76.9%, Cochran Q = 102, p < 0.001). Conclusions: This is the first systematic review and meta-analysis to synthesise the literature on ACEs and multimorbidity, showing a dose-dependent relationship across a large number of participants. It consolidates and enhances an extensive body of literature that shows an association between ACEs and individual long-term health conditions, risky health behaviours, and other poor health outcomes. [ABSTRACT FROM AUTHOR]

Objective: Examine the effect of childhood adversity on depression in older adults and the regulatory impact that social participation has on depression. Methods: Based on 6,704 standard-compliant research subjects, single factor analysis, multiple linear regression model, and tendency score matching were used to analyze the impact of childhood adversity on depression in older adults and the regulatory effect of social participation. Results: The depression rate is higher among women, young age, low education, unmarried, in agricultural households, older adults with low annual income, preretirement work type in agriculture, non-drinking, and those with two or more chronic diseases (p < 0.05). Children who experienced adversity as children are more likely to suffer from depression as adults (β = 0.513, 0.590, 0.954, 0.983, 1.221, 0.953, 0.718; p < 0.05). Through the tendency score, the result is matched with the endogenous test. As well, older adults are more likely to suffer psychological damage from a greater number of childhood adversities in their early years (β = 1.440, 2.646, 4.122; p < 0.001). It has been shown that social participation will reduce the negative impact of low-income family economic circumstances on depression among older adults of all ages (β = -0.459,-0.567; p < 0.01), aggravate depression resulting from "neighborhood void of mutual assistance" and "no more fun to play" for older adults of all ages (β = 1.024, 0.894; p < 0.01), and exacerbate depression resulting from "loneliness because there are no friends" for the oldest old (β = 0.476, 0.779; p < 0.05). Conclusion: Older adults who experience childhood adversity are more likely to suffer from depression. Social participation plays a regulatory role in the relationship between childhood adversity and depression in older adults. For older adults' mental health to improve, family and social adversity should be prevented, and moderate participation in society should be encouraged. [ABSTRACT FROM AUTHOR]

Few high-quality instruments are available to comprehensively screen for multiple interpersonal traumatic childhood experiences differentiated by developmental stage. One instrument assessing various forms of childhood trauma is the Maltreatment and Abuse Chronology of Exposure (MACE-X, Teicher & Parigger, 2015), which allows for the assessment of age at exposure for every item. The aim of this study is the development of a shorter version, which is suitable for screening. In- and out-patients (n = 719) of a somatic clinic were assessed with the German version of the 75-item MACE. Descriptive statistics, a nonparametric item response theory model (Mokken Scale Analysis), and factor analysis were combined to select items for a screening version. A screener (MACE-SCREEN) with 39 items allocated to five scales was developed. Scales differentiate between abuse types and neglect, direct experience vs. witnessing violence, and the age of the perpetrator (adults vs. peers). The scales showed good internal consistency (Alpha .78 to .91) and the total score a strong correlation with the total score of the long version (r = .96). This screening version is still comprehensive as it assesses exposure to various forms of interpersonal traumatic events, including peer violence and witnessing domestic abuse. As it also allows for the concurrent assessment of age at exposure, it lends itself to assessing exposure across developmental stages. [ABSTRACT FROM AUTHOR]

• Function and connectivity alteration in middle frontal gyrus (MFG) and insula play important roles in BDII-D. • Lower functions of insula and MFG were related to higher level of peripheral inflammation. • Lower insular function related to greater childhood trauma; lower MFG function linked to greater physical abuse. • Enhanced MFG-insula/mACC connectivity was related to greater depressive symptom while IL-1β moderated these associations. • Words count: 4,664. The functional alterations of the brain in bipolar II depression (BDII-D) and their clinical and inflammatory associations are understudied. We aim to investigate the functional brain alterations in BDII-D and their relationships with inflammation, childhood adversity, and psychiatric symptoms, and to examine the moderating effects among these factors. Using z-normalized amplitude of low-frequency fluctuation (zALFF), we assessed the whole-brain resting-state functional activity between 147 BDII-D individuals and 150 healthy controls (HCs). Differential ALFF regions were selected as seeds for functional connectivity analysis to observe brain connectivity alterations resulting from abnormal regional activity. Four inflammatory cytokines including interleukin (IL)-6, IL-1β, tumor necrosis factor (TNF)-α, and C-reactive protein (CRP) and five clinical scales including Hamilton Depression Scale (HAMD), Hamilton Anxiety Scale (HAMA), Positive and Negative Syndrome Scale (PANSS), Columbia-Suicide Severity Rating Scale (C-SSRS), and Childhood Trauma Questionnaire (CTQ) were tested and assessed in BDII-D. Partial correlations with multiple comparison corrections identified relationships between brain function and inflammation, childhood adversity, and psychiatric symptoms. Moderation analysis was conducted based on correlation results and previous findings. Compared to HCs, BDII-D individuals displayed significantly lower zALFF in the superior and middle frontal gyri (SFG and MFG) and insula, but higher zALFF in the occipital-temporal area. Only the MFG and insula-related connectivity exhibited significant differences between groups. Within BDII-D, lower right insula zALFF value correlated with higher IL-6, CRP, and emotional adversity scores, while lower right MFG zALFF was related to higher CRP and physical abuse scores. Higher right MFG-mid-anterior cingulate cortex (mACC) connectivity was associated with higher IL-1β. Moreover, IL-1β moderated associations between higher right MFG-mACC/insula connectivity and greater depressive symptoms. This study reveals that abnormal functional alterations in the right MFG and right insula were associated with elevated inflammation, childhood adversity, and depressive symptoms in BDII-D. IL-1β may moderate the relationship between MFG-related connectivity and depressive symptoms. [ABSTRACT FROM AUTHOR]

Background While childhood adversity (CA) is known to be associated with multiple adverse outcomes, its link with dementia is an area with limited exploration and inconsistent agreement. The study aimed to examine the longitudinal associations of CA with incident all-cause dementia and to quantify the potential mediating pathways. Methods Data from the UK Biobank. CA, encompassing neglect and abuse, was evaluated retrospectively by an online mental health questionnaire. Physical performance, psychological factors, lifestyles, and biological indicators assessed at baseline were considered potential mediators. Incident all-cause dementia was defined by International Classification of Diseases, Tenth Revision codes obtained through self-reported medical conditions, primary care, hospital admission, and death registrations. Cox proportional hazard models were applied to estimate the longitudinal associations. Mediation analyses were conducted on potential mediators to examine their contribution. Results This cohort study comprised 150 152 nondemented individuals (mean [ SD ] age, 55.9 [7.7] years) at baseline (2006–2010). Compared to individuals who did not experience CA, those exposed to any CA exhibited a 30.0% higher risk of dementia (hazard ratio = 1.300, 95% confidence interval [CI]: 1.129–1.496). Each additional CA was associated with a 15.5% (95% CI: 8.8%–22.5%, p for trend <.001) increased dementia risks. Depression, smoking, and low grip strength explained 8.7%, 2.4%, and 0.9% of the associations, respectively. Biomarkers involving inflammation, erythrocytes, liver, and kidney function mediated the associations by 0.6%–1.4%. Conclusions The study revealed the detrimental effects of CA on dementia and identified some potential mediators, namely depression, smoking, low grip strength, and several targeted biomarkers. In addition to calling more attention to CA, the findings underscore the importance of interventions targeting modifiable mediators in preventing dementia. [ABSTRACT FROM AUTHOR]

Assessment practices for measuring adverse life events (ALEs) are often characterized by considerable variability, which is associated with inconsistency and reproducibility issues when conducting research on children with ALE exposure. One aspect of assessment variability for caregiver report of children's ALE history that has received minimal attention is assessment format. To address this issue, the current study evaluated concordance between two main ALE assessment formats: interviews and questionnaires. This involved examining overall endorsement of ALEs and concordance among multiple characteristics of ALE exposure, including type, polyvictimization, frequency, severity, and age of onset. Fifty-eight caregivers (M age = 33.72; 60% Black; 55% below the federal poverty line) of preschool and school-age children were administered an ALE assessment in both a questionnaire and interview format across two sessions. The sum scores and concordance rates between format responses were compared based on ALE type, polyvictimization, frequency, severity, and age of onset of exposure. Results indicated that most total or sum scores were similar between formats, with the exception of ALE severity scores. However, there was most often low-to-moderate concordance across the 50 types of ALEs examined in the current study, suggesting that a different constellation of events comprised each sum or total score. This was also the case across all characteristics of the ALEs and most notably for the severity of ALE. Based on these findings, the format of assessment may be associated with inconsistent reporting of children's ALE exposure across multiple characteristics of ALE. Researchers may need to utilize multiple types of ALE assessments when relying on caregiver report of a child's ALEs. [ABSTRACT FROM AUTHOR]

Background: Adverse childhood experiences can impact physical and mental health throughout the lifespan. To support families experiencing adversity and improve child health and developmental equity, an integrated, multi-sector response is required. Child and Family Hubs (Hubs) are a feasible and acceptable approach to providing such a response. In the Australian context, a number of federal and New South Wales (NSW) state policies support an integrated, multi-sector response using Hubs to support families experiencing adversity. This study examined NSW policy stakeholder and health service manager perspectives on the barriers and enablers to translating policy into practice in the implementation of Child and Family Hubs. Methods: Semi-structured interviews were conducted with 11 NSW government policy stakeholders and 13 community health service managers working in child and family policy and planning or child and family community-based services. Interviews were of 30–60 min duration and explored stakeholder knowledge, perspectives and experiences around childhood adversity, and barriers and enablers to operationalizing policies supporting Hubs. Analysis of barriers and facilitators to implementation of Hub models of care was undertaken using the Consolidated Framework for Implementation Research (CFIR). Results: Key barriers that emerged included short-term and inconsistent funding, lack of resourcing for a Hub co-ordinator, limited support for evaluation and insufficient time to plan for Hub implementation. Key enablers included flexibility and adaptability of Hub models to meet local needs, formal change management processes, strong governance structures and engagement among Hub practitioners. Key insights included the importance of targeted strategies to support sustained individual practice change and the need for organization-wide commitment to enable the successful adoption and maintenance of the Hub model of care. Conclusions: This study provides valuable insights and contributes evidence around what is needed to strengthen and support the operationalization and scalability of the Hub model of care. Key recommendations for Hub practitioners include the importance of formal change management processes and establishment of strong governance structures, while key recommendations for policymakers include the need for sustainable Hub funding and a standardized, evidence-based framework to support Hub implementation and evaluation. [ABSTRACT FROM AUTHOR]

Is childhood adversity associated with biological aging, and if so, does sex modify the association, and do lifestyle and mental health mediate the association? A lifespan analysis is conducted using data on 142 872 participants from the UK Biobank to address these questions. Childhood adversity is assessed through the online mental health questionnaire (2016), including physical neglect, physical abuse, emotional neglect, emotional abuse, sexual abuse, and a cumulative score. Biological aging is indicated by telomere length (TL) measured from leukocyte DNA using qPCR, and the shorter TL indicates accelerated biological aging; a lifestyle score is constructed using body mass index, physical activity, drinking, smoking, and diet; mental disorder is assessed using depression, anxiety, and insomnia at the baseline survey. The results reveal a sex‐specific association such that childhood adversity is associated with shorter TL in women after adjusting for covariates including polygenic risk score for TL, but not in men. Unhealthy lifestyle and mental disorder partially mediate the association in women. The proportions of indirect effects are largest for sexual and physical abuse. These findings highlight the importance of behavioral and psychological interventions in promoting healthy aging among women who experienced childhood adversity, particularly sexual and physical abuse. [ABSTRACT FROM AUTHOR]

Childhood adversity is a well-established risk factor for adolescent acting-out behaviors such as self-harm, bingeing, substance abuse, and aggressive behavior. From a mentalizing perspective, acting-out behaviors are understood as resulting from a combination of impairments in mentalizing and epistemic vigilance that are a consequence of childhood adversity. Yet, few studies have investigated these assumptions. The current study investigated the potential mediating role of mentalizing impairments and epistemic vigilance in the relationship between childhood adversity and acting-out behaviors in adolescents, oversampled for risk status for psychopathology (N = 451, mean age = 15.40 years). Structural equation modeling showed a strong, direct relationship between childhood adversity and acting-out behaviors, confirming the importance of traumatic childhood experiences for adolescent acting-out behaviors. This relationship was partially mediated by both mentalizing difficulties and epistemic vigilance, explaining about 40% of the total variance. These results support the importance of focusing on strengthening mentalizing abilities and lowering epistemic hypervigilance in psychotherapeutic work with adolescents who have experienced childhood trauma. [ABSTRACT FROM AUTHOR]

Experiencing parental deportation during childhood is associated with higher rates of mental health and behavioral health challenges. This adversity may be exacerbated by the uncertainty of what is happening to their deported parent and to their family system following a deportation experience. Effective clinical intervention can reduce the likelihood and/or severity of physical health, mental health and behavioral health difficulty caused by the trauma of parental deportation; however, clinicians have insufficient resources and guidance on effectively engaging with children and their families following parental deportation. Semi-structured qualitative interviews were conducted with English-speaking Latino individuals from the United States who experienced parental deportation between the ages of 6 and 17 (n = 10). Using interpretive phenomenology analytic procedures, three major themes emerged related to participants' experiences of their family after their parent's deportation: (a) I wish I knew what was happening, (b) I wish people had checked in on my emotions, and (c) I wish people had been supportive and included us in the conversation. These findings are examined from an ambiguous loss framework to provide clinical implications of children's needs after parental deportation. Suggestions are offered from the adults who lost their parent to deportation as a child about what they needed following their loss. By understanding what children need in these moments of crisis, practitioners, providers, and others are better prepared to address this form of complex childhood adversity. [ABSTRACT FROM AUTHOR]

Objective To investigate the brain regions that play a key role in the impact of childhood adversity on cognitive function, based on the mediation effect analysis of debiased machine learning framework. Methods The dataset, consisting of 460 volunteers, was randomly partitioned into a training set (n=368) and a validation set (n=92). To enhance the stability of the results, this study utilized a debiased machine learning mediation analysis method to develop models and draw conclusions from the training set, which were then validated with the validation set. Finally, the Bonferroni method was employed to correct for significance in the identified brain regions. Results The experimental results for the training set and validation set were similar. The efficacy of the left superior parietal lobule was significant (validation set P<0.001), exhibiting a positive effect (validation set Effect Size=0.78). The right frontopolar cortex, anterior cingulate cortex, and left inferior temporal gyrus were also significant (P<0.001 for both training set and validation set) and were identified as having a negative effect in this process (validation set Effect Size =-0.037 and -0.034, respectively). The associations between the brain regions with significant effects and cognitive function are supported by existing literature. Conclusion This study employed mediation analysis methods to investigate the mechanisms underlying the impact of childhood adversity on cognitive function. The results indicate that the left superior parietal lobule, right rostral anterior cingulate cortex, and left inferior temporal gyrus play crucial roles in the process of childhood adversity affecting cognitive function. Specifically, the left superior parietal lobule exhibits a positive effect, while the right rostral anterior cingulate cortex and left inferior temporal gyrus exhibit negative effects. [ABSTRACT FROM AUTHOR]

Background and Hypothesis Childhood adversity is often described as a potential cause of incident psychotic experiences, but the underlying mechanisms are not well understood. We aimed to examine the mediating role of cognitive and psychopathological factors in the relation between childhood adversity and incident psychotic experiences in early adulthood. Study Design We analyzed data from the Avon Longitudinal Study of Parents and Children, a large population-based cohort study. Childhood adversity was measured prospectively from birth to age 11 years, mediators (anxiety, depression, external locus of control [LoC], negative symptoms) were assessed at approximately 16 years of age, and incident psychotic experiences were assessed at ages 18 and 24 years. Mediation was examined via the counterfactual g -computation formula. Study Results In total, 7% of participants had incident suspected or definite psychotic experiences in early adulthood. Childhood adversity was related to more incident psychotic experiences (ORadjusted = 1.34, 95% CI = 1.21; 1.49), and this association was partially mediated via all mediators examined (proportion mediated: 19.9%). In separate analyses for each mediator, anxiety, depression, external LoC, and negative symptoms were all found to mediate the link between adversity and incident psychotic experiences. Accounting for potential confounders did not modify our results. Conclusions Our study shows that cognitive biases as well as mood symptomatology may be on the causal pathway between early-life adversity and the development of psychotic experiences. Future studies should determine which mediating factors are most easily modifiable and most likely to reduce the risk of developing psychotic experiences. [ABSTRACT FROM AUTHOR]

The rapid transition to online learning has exacerbated procrastination behavior, further complicated by students' mental health challenges, such as depression, anxiety, and stress, which lead to delayed educational tasks and diminished academic performance. This study investigates the efficacy of a resilience intervention program based on the three-factor model of personal resilience in reducing academic procrastination among Egyptian primary school students during the COVID-19 pandemic. This quasi-experimental research involved a sample of 100 fourth-grade students who demonstrated high levels of procrastination, indicated by scores above 70% on the Pure Procrastination Scale. Students were randomly divided into two groups-an experimental group, which received resilience training, and a control group, which did not-to assess the intervention's impact on academic procrastination. Qualitative analyses of the feedback from students, teachers, and parents, coupled with pre- and post-intervention questionnaires, were utilized to evaluate the program's effectiveness. Initial findings revealed no significant differences between the groups before the intervention. However, significant improvements in the experimental group's procrastination levels were observed immediately and one month after the intervention, suggesting the potential ability of resilience training to enhance students' academic performance and well-being. Results advocate for the inclusion of resilience-building activities within educational curricula to effectively address academic procrastination. The purpose of this study is to propose suggestions to reduce academic procrastination in primary school students. These results have implications for educators and professionals working with children, emphasizing the value of fostering resilience skills to support academic achievement and well-being. [ABSTRACT FROM AUTHOR]

Background: Childhood adversities may lead to decreased activity participation in later life, impacting memory health in ageing adults. Childhood adversities related to deprivation and threat, as conceptualized by the Dimensional Model of Adversity, can exhibit distinct impacts on cognitive and emotional outcomes in children and younger adults. This study examined the potential influence of childhood deprivation and threat on memory function in later life and the mediating role of activity participation in these relationships. Methods: This study used data from the first wave of Panel Study of Active Ageing and Society (PAAS), a representative survey of Hong Kong residents aged 50 or above (N = 1,005). Key variables included late-life memory function measured by delayed recall test, deprivation- and threat-related childhood adversities, and the frequency of participation in informal and formal types of activities. Mediation tests were used for analysis. Results: Childhood deprivation was associated with a lower late-life memory function, whereas threat was not. The negative effects of childhood deprivation and its subdomain, economic hardship, on memory function were mediated by activity participation. Total participation scores presented the strongest mediating effect (17.3–20.6%), with formal activities playing a more substantial mediating role than informal activities in mitigating the effect of childhood deprivation. Conclusions: These findings expand the applicability of the Dimensional Model of Adversity to ageing populations, highlighting the influence of deprivation on life-long cognitive development. Furthermore, this study revealed an indirect mechanism by which childhood deprivation affects memory health in old age through diverse activity participation. [ABSTRACT FROM AUTHOR]

Introduction: This study aimed to investigate the relationship between adverse childhood experiences (ACEs) and dental anxiety among Chinese adults in Hong Kong. Methods: A cross-sectional survey was conducted at a university in Hong Kong. The recruiting period and data collection started in January 2023 and ended in June 2023. Participants completed an online questionnaire that assessed ACEs (using the Adverse Childhood Experiences International Questionnaire -- ACE-IQ) and dental anxiety (using the Modified Dental Anxiety Scale -- MDAS and Dental Fear Survey -- DFS). The study examined the impacts of both cumulative (i.e., total number) and independent ACE components on dental anxiety. To explore the relationships between cumulative ACEs, individual ACE components and dental anxiety (MDAS and DFS score), Pearson correlations, linear regression and logistic regression were conducted. Results: Significant associations were observed between ACEs and dental anxiety among 171 subjects. Cumulative ACEs were positively correlated with MDAS scores (r = 0.169, p = 0.027) and DFS scores (r = 0.253, p < 0.001). The odds of an individual having high dental anxiety increased by 26-43% for every additional increase in the number of ACEs. Individual types of ACEs, such as emotional and physical neglect, sexual abuse, and household substance abuse, significantly influenced the likelihood of having high dental anxiety. Discussion: The results showed a positive association between ACEs and dental anxiety, highlighting the impact of ACEs on dental anxiety. Dental practitioners should consider inquiring about a patient's ACE history to develop personalized treatment plans. [ABSTRACT FROM AUTHOR]

The present study furthers understanding of how childhood adversity connects to inflammation and, in turn, poor health. Using the publicly available Midlife in the United States II (MIDUS II) dataset, we test a recent theoretical model that suggests emotion regulation is a potential mechanism of associations between adversity and inflammation. We examined the indirect effects of various types of adversity (e.g., stressful events, maltreatment, threat, and deprivation) on inflammation via two emotion regulation strategies (i.e., expressive suppression and reappraisal). Participants included 1096 adults without a history of cancer or HIV/AIDS who had completed the initial MIDUS II follow up and a sub-study examining biomarkers. Participants completed self-report measures inquiring about psychosocial factors including stressful life events, childhood trauma, and emotion regulation as well as provided blood samples. Bivariate correlation indicated that multiple forms of childhood adversity were associated with both C-reactive protein and fibrinogen. Deprivation, as measured by a stressful life events scale, was positively associated with both reappraisal and suppression. Tests of indirect effects indicated that deprivation was positively associated with fibrinogen through both emotion regulation strategies, particularly for female participants. Our findings partially support recent theory positing emotion regulation as a pathway through which childhood adversity may impact inflammation in adulthood. Further, deprivation may be particularly critical in understanding how adversity is connected to maladaptive emotion regulation and inflammation. Emotion regulation may be an important treatment target to mitigate the negative impact of childhood adversity on health and well-being. [ABSTRACT FROM AUTHOR]

Introduction: The present study evaluated whether adverse childhood experiences (ACEs) are significantly and independently associated with six key outcomes in the Polish general population: (1) lifetime suicide attempt, (2) self-mutilation, (3) potential problem drinking, (4) use of street drugs, (5) visiting a psychologist/psychotherapist, and (6) visiting a psychiatrist. We also investigated whether ACEs explain a significant proportion of variability in generalized self-efficacy. Material and methods: Six hundred and fifty-nine individuals completed the ACE Study questionnaire (physical, verbal, and sexual abuse; neglect; select family dysfunctions) and three additional questions [ACE (13) questionnaire]: witnessing (1) a family member's suicide attempt or (2) death due to any cause except completed suicide, and (3) a stranger's death due to any cause (e.g., traffic accident). Generalized self-efficacy was assessed with the Generalized Self-Efficacy Scale. Results: The likelihood of lifetime use of street drugs, potential problem drinking, and visiting a psychologist/psychotherapist and psychiatrist increased as ACE and ACE (13) score increased. As compared to scores of < 4, ACE (13) scores of = 4 were associated with a 10.8-fold increased likelihood of self-mutilation, a 3.26-fold increased likelihood of potential problem drinking, a 5.72-fold increased likelihood of visiting a psychologist/psychotherapist, and a 6.71-fold increased likelihood of visiting a psychiatrist. ACE (13) score explained 1.2% of the variability in generalized self-efficacy. Conclusions: The present study identified a strong association between childhood adversity and increased likelihood of lifetime self-mutilation, potential problem drinking, visiting a psychologist/psychotherapist, and visiting a psychiatrist. Generalized self-efficacy may be an important target for secondary intervention following childhood adversity. [ABSTRACT FROM AUTHOR]

This study compared borderline personality disorder (BPD) and bipolar 2 disorder (BP 2 disorder) with respect to reported childhood trauma and Five-Factor personality traits using the Childhood Trauma Questionnaire (CTQ) and the NEO Five-Factor Inventory (NEO-FFI). Participants were 50 men and women, aged 18-45, with DSM-5-diagnosed BPD and 50 men and women in the same age group with DSM-5-diagnosed BP 2 disorder. Participants could not meet criteria for both BPD and BP 2 disorder. Borderline participants had significantly higher scores on the neuroticism subscale and significantly lower scores on the agreeableness subscale of the NEO-FFI. After correction for multiple comparisons, there were no between-group differences on CTQ scores. Study results suggest that BPD and BP 2 disorder differ primarily with respect to underlying temperament/genetic architecture and that environmental factors have only a limited role in the differential etiologies of the two disorders. [ABSTRACT FROM AUTHOR]

To identify specific eating behavior pathways that mediate associations between financial difficulties, negative life events, and maternal depressive symptoms from 0 to 5 years and cardiometabolic risk in adolescence. Method: Hypotheses were tested with data from birth to age 15 years using the Avon Longitudinal Study of Parents and Children, a birth cohort in the United Kingdom (n= 3,887 for current analyses). Mothers reported on financial difficulties, negative life events, and maternal depressive symptoms at multiple points from 0 to 5 years and reported on worry about child overeating at 8 years. Youth selfreported restrained, emotional, and external eating at age 14. Youth completed a cardiometabolic health assessment at age 15 where waist circumference, triglycerides, high-density lipoprotein, and insulin resistance were measured. Longitudinal structural equation modeling with bootstrapping was used to test mediation models. Results: Greater negative life events and maternal depressive symptoms predicted greater parental worry about child overeating at age 8, which directly predicted greater restrained and emotional eating at 14 and cardiometabolic risk at 15. Restrained and emotional eating at 14 directly predicted greater cardiometabolic risk at age 15. Conclusions: Negative life events and maternal depressive symptoms in infancy/early childhood are associated with cardiometabolic risk in adolescence through pathways of parental worry about child overeating in middle childhood and youth-reported restrained and emotional eating in adolescence. [ABSTRACT FROM AUTHOR]

Childhood adversity (CA) and resilience may impact on paranoia, but mechanisms underlying these associations are largely unknown. In this study, we investigated two potential candidates: irrational beliefs and affective disturbance. Moreover, we investigated the potential moderating role of COVID-19 perceived stress in these associations. A community sample (N = 419, m age = 27.32 years, SD = 8.98; 88.10% females) completed self-report measures. Results indicated that paranoia was significantly associated with CA and resilience (p <.05), and both irrational beliefs and affective disturbance (i.e., depressive and anxiety symptoms) mediated the associations between CA and paranoia. Moreover, depressive and anxiety symptoms partially explained the mediating role of irrational beliefs. These predictive models explained up to 23.52% of variance in paranoia (F(3,415) = 42.536, p <.001). Findings on resilience and paranoia replicated these results, and COVID-19 perceived stress moderated the association between resilience and ideas of persecution. Overall, these findings underscore the importance of irrational beliefs, depressive and anxiety symptoms in high CA or low resilience individuals experiencing paranoia. [ABSTRACT FROM AUTHOR]

OBJECTIVE: To investigate the relationship between of distinct domains of childhood disadvantage and cognitive performance among older adults within the context of a middle-income country. METHODS: This study used baseline data (2015/2016) from the Brazilian Longitudinal Study of Aging (ELSI), a nationally representative cohort of 9412 adults aged 50 and over. Nine childhood exposure variables were grouped into three domains (family SES, childhood health, and cultural capital), for which scores were created. Survey-weighted Ordinary Least Squares (OLS) regressions estimated the association childhood disadvantage with cognitive performance as measured by immediate memory, late memory and semantic verbal fluency. Mediation analysis assessed whether adulthood socioeconomic status (SES) mediated this relationship of interest. RESULTS: Important disparities in cognitive performance were observed, particularly in terms of age, education, income, occupational status. Before controlling for adulthood SES in the multivariable analysis, all domains of childhood disadvantage were found to be associated with lower cognitive performance across all three measures. After inclusion of adulthood SES variables, the observed associations only remained for semantic verbal fluency. Formal mediation analysis indicated that adulthood SES mediates 47.9% (95% CI: 34.3%-78.6%) of the association between later-life verbal fluency and poor childhood health, and 49.9% (95% CI: 43.6%-57.8%) of the association between later-life verbal fluency and low childhood cultural capital. CONCLUSIONS: We found that childhood disadvantage is associated with low performance in memory tests and semantic verbal fluency tests among older Brazilians. Adulthood SES fully mediated the association between all domains of childhood disadvantage and memory performance and only partially mediated its association with verbal fluency. Our findings support policy efforts to enhance early childhood development and improve adulthood SES, and guide additional research to better the mechanisms driving these relationships.

BackgroundOutdoor air pollution, including ozone (O3) pollution, and childhood family environments may interact and impact asthma exacerbations in children. Previous epidemiology studies have primarily focused on stress in the home, rather than support, and whether psychosocial factors modify the association between pollution and health outcomes, rather than whether pollution exposure modifies associations between psychosocial factors and health outcomes.MethodsData from the cross-sectional 2003 representative, population-based California Health Interview Survey were linked with air quality monitoring data on O3 pollution from the California Air Resources Board. Adolescents (N = 209) ages 12-17 who reported an asthma diagnosis and lived within 5 mi of the nearest air monitoring station had linked O3 data for a 12-month period preceding the survey interview date. Adolescents reported perceived available support from an adult at home and frequency of asthma symptoms.ResultsIn unadjusted models, for adolescents living in high O3 pollution regions, greater perceived support was related to lower asthma symptom frequency. Follow-up analyses suggested that the most plausible interpretation of the interaction was that O3 exposure modified the association between perceived support and symptom frequency. O3 × perceived support interactions were not statistically significant after adjusting for covariates.ConclusionsThese data provide preliminary evidence that the association between the lack of support in the home environment and worse asthma symptoms may be stronger in areas with higher O3 exposure. Future work may benefit from incorporating personal pollution exposure assessments, comprehensive family environment assessments, and longitudinal follow-up of asthma exacerbations over time.

Background: Adverse childhood experiences (ACEs) may be associated with worse physical and mental health in adulthood, and low physical activity engagement, but the relationships are not fully understood. Objectives: To establish the scope of the literature exploring associations between ACEs, physical activity, and physical and mental health. Methods: We conducted this scoping review according to PRISMA-ScR guidelines. We searched MEDLINE, Scopus, SPORTDiscus, and PsycInfo for relevant articles. Results: Eighteen studies were included, 17 observational and 1 randomized controlled trial. The majority of studies were cross-sectional and employed self-reported physical activity and ACE measures. Six studies explored physical health, 9 explored mental health, and 3 explored both. Associations between ACEs and poor physical health outcomes (poor self-reported physical health, inflammation, high resting heart rate, and obesity) were consistently weaker or attenuated among those who were physically active. Physical activity may also moderate the associations between ACEs and depressive symptoms, psychological functioning, and health-related quality of life. Conclusion: Associations between ACEs and poor physical and mental health were observed in those with less frequent physical activity engagement, though the majority of evidence relies on cross-sectional observational designs with self-report instruments. Further research is required to determine whether physical activity can prevent or treat poor physical and mental health in the presence of ACEs. [ABSTRACT FROM AUTHOR]

Childhood adversity is a leading transdiagnostic risk factor for psychopathology, being associated with an estimated 31-62% of childhood-onset disorders and 23-42% of adult-onset disorders (Kessler et al., 2010). Major unresolved theoretical challenges stem from the nonspecific and probabilistic nature of the links between childhood adversity and psychopathology. The links are nonspecific because childhood adversity increases risk, through a range of mechanisms, for diverse forms of psychopathology and are probabilistic because not all individuals exposed to childhood adversity develop psychopathology. In this article, we propose a path forward by focusing on stress phenotypes, defined as biobehavioral patterns activated in response to stressors that can disrupt future functioning when persistent (e.g., reward seeking, social withdrawal, aggression). This review centers on the accumulating evidence that psychopathology appears to be more strongly predicted by behavior and biology during states of stress. Building on this observation, our theoretical framework proposes that we can model pathways from childhood adversity to psychopathology with greater specificity and certainty by understanding stress phenotypes, defined as patterns of behavior and their corresponding biological substrates that are elicited by stressors. This approach aims to advance our conceptualization of mediating pathways from childhood adversity to psychopathology. Understanding stress phenotypes will bring us closer to "precision mental health," a person-centered approach to identifying, preventing, and treating psychopathology. (PsycInfo Database Record (c) 2023 APA, all rights reserved).

ObjectiveTo understand the association between psychosocial stressors and cardiovascular health by evaluating: (a) lifespan patterns of childhood and adulthood stressors in relation to hemodynamic acute stress reactivity and recovery and (b) the role of optimism in these associations.MethodParticipants (n = 1,092, 56% women, 21% racial/ethnic minority, Mage = 56.2) were from the Midlife in the United States Study II Biomarker Project. Lifespan profiles of psychosocial stressor exposure (low lifespan exposure, high childhood only, high adulthood only, persistent exposure) were constructed from responses to the Childhood Trauma Questionnaire and a life events inventory. Optimism was measured with the Life Orientation Test-Revised. Hemodynamic acute stress reactivity to and recovery from cognitive stressors were assessed using a standardized laboratory protocol involving continuous measurements of systolic and diastolic blood pressure (BP) and baroreflex sensitivity (BRS).ResultsCompared with the low lifespan exposure group, the high childhood- and persistent-exposure groups showed lower BP reactivity, and to a lesser extent, slower BP recovery. Persistent exposure was also associated with slower BRS recovery. Optimism did not modify the association between stressor exposure and any hemodynamic acute stress responses. However, in exploratory analyses, greater stressor exposure across all developmental periods was indirectly associated with reduced BP acute stress reactivity and slower recovery via lower optimism levels.ConclusionsFindings support childhood as a unique developmental period wherein high adversity exposure may exert an enduring influence on adulthood cardiovascular health by limiting individuals' capacity to cultivate psychosocial resources and altering hemodynamic responses to acute stressors. (PsycInfo Database Record (c) 2023 APA, all rights reserved).

Abstract Background Unintended (unwanted) pregnancy is a sexual and reproductive health issue with psychosocial consequences for the individual, their family, and society. However, the relationship between social support and related mental health issues, like depression and the effects of childhood adversity, is poorly studied. This study aims to explore the connections between childhood adversity, perceived social support, and depressive symptoms in pre-abortion women (women who have decided to have an abortion) in a clinical setting, based on the common risk factor approach and social support theory. Methods A total of 299 pre-abortion Chinese women 18–45 years were recruited in a hospital in Shantou, China. Hierarchical linear regression analyses were employed to examine the relative effects of childhood adversity and sources of social support on depressive symptoms, controlling for sociodemographic influences. Results The results show that 37.2 percent of participants reported at least one adverse experience in childhood. More than half of the respondents were at risk for depression. Results of regression analysis showed that childhood adversities were negatively associated with depressive symptoms before sources of social support were entered into the model. However, when the sources of perceived social support were added, the effect of childhood adversity was not significant. Perceived social support explained the additional 15 percent variance in depressive symptoms. Additionally, being married (β = -.12, p