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Objective: We examine role of ACEs and pathways to risk of opioid misuse among young adults. Participants and Methods: A cross-sectional survey of validated measures of ACEs, risk of opioid misuse, and health conditions with a sample of 1,402 students from a large public university followed by multivariate logistic regression and pathway analysis. Results: Majority (61%) of participants reported at least one ACE. A dose-response relationship between numbers of ACEs with risk for opioid misuse was present. Compared to participants with no ACEs, participants with [greater than or equal to]4 ACEs and 0-3 ACEs were 2.93 (95% CI: 1.95, 4.39; p < 0.001) and 1.96 (95% CI: 1.46, 2.65; p < 0.001) times more likely to be at risk for opioid misuse, respectively. Having at least one existing or past health condition significantly mediated the association. Conclusions: Our findings suggest need to include assessment of ACEs as a screening criterion for opioid prescription and administration among college-aged individuals.

Objective: We examine role of ACEs and pathways to risk of opioid misuse among young adults. Participants and Methods: A cross-sectional survey of validated measures of ACEs, risk of opioid misuse, and health conditions with a sample of 1,402 students from a large public university followed by multivariate logistic regression and pathway analysis. Results: Majority (61%) of participants reported at least one ACE. A dose-response relationship between numbers of ACEs with risk for opioid misuse was present. Compared to participants with no ACEs, participants with ≥4 ACEs and 0–3 ACEs were 2.93 (95% CI: 1.95, 4.39; p<0.001) and 1.96 (95% CI: 1.46, 2.65; p<0.001) times more likely to be at risk for opioid misuse, respectively. Having at least one existing or past health condition significantly mediated the association. Conclusions: Our findings suggest need to include assessment of ACEs as a screening criterion for opioid prescription and administration among college-aged individuals. [ABSTRACT FROM AUTHOR]

Understanding excessive absenteeism is important to ameliorating the negative outcomes associated with the behavior. The present study examined behavioral reinforcement profiles of school refusal behavior: negative reinforcement (avoidance) and positive reinforcement (gaining parental attention or receiving tangible benefits from not attending school). School social workers obtained information on school refusal behavior for 99 upper-elementary and middle school students referred for attendance problems. Three profiles were identified: 17.2 percent missed school to avoid fear- or anxiety-producing situations, escape from adverse social or evaluative situations, or gain positive tangible rewards (multiple profile); 60.6 percent missed school to gain parental attention or receive tangible rewards (positive reinforcement); and 22.2 percent had no profile. All three groups significantly differed in mean scores for behavioral difficulties, with children in the multiple profile group having the highest level of behavioral problems and children in the no profile group having the lowest. Children in the multiple profile group had higher mean scores on frequency of victimization and total number of traumatic or stressful events than did those in the other groups. Although more studies are needed, these findings suggest that school refusal behavior assessments may serve as a tool to better understand the phenomena of school attendance problems.

Objective: To examine relationships between childhood autobiographical memory disturbance (CAMD) and adverse childhood experiences (ACEs) which are defined as common forms of child maltreatment and related traumatic stressors. Methods: We use the ACE score (an integer count of eight different categories of ACEs) as a measure of cumulative exposure to traumatic stress during childhood. In a cross sectional analysis we assess the relationship of the ACE score to the prevalence of CAMD in a sample of 9,460 relatively healthy adults evaluated for wellness care at a southern California health maintenance organization between August 1995 and March 1996. In addition, we examined possible secular influences by examining association among each of four birth cohorts. Logistic regression was used to obtain the adjusted relative odds of CAMD associated with increasing ACE score. Results: Overall, the age-standardized prevalence of CAMD was 18% (men: 15%; women: 19%). As the ACE score increased, the prevalence of CAMD increased in a graded fashion for both men and women (p for trend less than 0.0001). After adjustment for age, sex, race/ethnicity, and education, adults with an ACE score greater than or equal to 6 were 5.9 (95% CI, 4.4-7.9) times more likely to have CAMD compared to adults with an ACE score of 0. The prevalence of CAMD increased with each successive birth cohort, and graded relationships between the ACE score and CAMD were observed among each of the four birth cohorts though no statistical difference in the association was found across birth cohorts. Conclusions: The accumulation of ACEs across several domains is associated CAMD among men and women and in each of four birth cohorts. Further research is needed that describes the prevalence of CAMD in population-based samples and that examines whether impaired memory is a marker for persons neurobiologically affected by multiple forms of child maltreatment and related traumatic stressors.

This retrospective cohort study assessed the relationship of childhood sexual abuse (CSA) to other categories of adverse childhood experiences (ACEs), such as childhood abuse, neglect, and parental separation/divorce. Adults reporting CSA experienced a 1.6- to 3.4-fold greater likelihood of experience each category of ACE. The ACE score was also positively related to the severity, duration, and frequency of CSA. (Contains references.) (Author/DB)