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1.
Adverse childhood experiences (ACEs), such as childhood abuse, neglect, and household dysfunction, have been identified as salient risk factors for adult depression. However, not all individuals who experience ACEs go on to develop depression. The extent to which resilience- or the ability to demonstrate stable levels of functioning despite adversity- may act as a buffer against depression among individuals with a history of ACEs has not been adequately examined. To address the associations between ACEs, depression, and resilience, 4006 adult participants were recruited from primary care clinics. Participants completed self-report questionnaires including: the Adverse Childhood Experiences Questionnaire, a retrospective measure of childhood adversity; the Patient Health Questionnaire-9, a measure of the presence and severity of the major symptoms of depression; and the Connor Davidson Resilience Scale, a measure of psychological resilience. Results from regression analyses indicated that, while controlling for a range of demographic variables, both ACEs and resilience independently predicted symptoms of depression, F(9, 3040) = 184.81, R2 = 0.354. Further, resilience moderated the association between ACEs and depression, F(10, 3039) = 174.36, p < 0.001, R2 = 0.365. Specifically, the association between ACEs and depression was stronger among individuals with low resilience relative to those with high resilience. This research provides important information regarding the relationships among ACEs, resilience, and depression. Results have the potential to inform the development of treatments aimed to reduce symptoms of depression among primary care patients with a history of childhood adversity.  相似文献   

2.
Adverse childhood experiences (ACE) tend to be interrelated rather than independently occurring. There is a graded effect associated with ACE exposure and pathology, with an increase when ACE exposure is four or more. This study examined a sample of active individuals (n = 129) to determine distribution patterns and relationships between ACEs, attachment classification, unresolved mourning (U), and disclosure difficulty. The results of this study demonstrated a strong relationship between increased ACEs and greater unresolved mourning. Specifically, the group differences for individuals who experienced no ACE (n = 42, 33%), those with 1–3 ACEs (n = 48, 37.8%), and those with ≥4 ACEs (n = 37, 29.1%) revealed a pattern in which increased group ACE exposure was associated with greater lack of resolution for past trauma/loss experiences, more adult traumatic events, and more difficulty disclosing past trauma. Despite ≥4 ACEs, 51.4% of highly exposed individuals were classified as secure in the Adult Attachment Interview. Resilience in this group may be related to a combination of attachment security, college education, and engagement in meaningful activities. Likewise, adversity may actually encourage the cultivation of more social support, goal efficacy, and planning behaviors; factors that augment resilience to adversity.  相似文献   

3.
Adverse Childhood Experiences (ACEs) such as child abuse are related to poor health outcomes. Spanking has indicated a similar association with health outcomes, but to date has not been considered an ACE. Physical and emotional abuse have been shown in previous research to correlate highly and may be similar in nature to spanking. To determine if spanking should be considered an ACE, this study aimed to examine 1): the grouping of spanking with physical and emotional abuse; and 2) if spanking has similar associations with poor adult health problems and accounts for additional model variance. Adult mental health problems included depressive affect, suicide attempts, moderate to heavy drinking, and street drug use. Data were from the CDC-Kaiser ACE study (N = 8316, response rate = 65%). Spanking loaded on the same factor as the physical and emotional abuse items. Additionally, spanking was associated with increased odds of suicide attempts (Adjusted Odds Ratios (AOR) = 1.37; 95% CI = 1.02 to1.86), moderate to heavy drinking (AOR) = 1.23; 95% CI = 1.07 to 1.41), and the use of street drugs (AOR) = 1.32; 95% CI = 1.4 to 1.52) in adulthood over and above experiencing physical and emotional abuse. This indicates spanking accounts for additional model variance and improves our understanding of these outcomes. Thus, spanking is empirically similar to physical and emotional abuse and including spanking with abuse adds to our understanding of these mental health problems. Spanking should also be considered an ACE and addressed in efforts to prevent violence.  相似文献   

4.
Using the 2012–2013 National Epidemiologic Survey on Alcohol and Related Conditions data, we examined the associations of ten types of adverse childhood experiences (ACEs) with (1) lifetime suicide attempts and (2) number and age of attempts among U.S. adults aged 18+. In a case-control design, suicide attempters (5.14% of the full sample) were matched with never attempters (matched sample N = 3912) on nine mental and substance use disorders. ACE rates were higher among attempters (3.30 [SE = 0.07]) than their matched controls (2.19 [SE = 0.06]). Results from multivariable logistic regression analyses showed that sexual abuse and parental/other family member’s mental illness were associated with increased odds of having attempted suicide among both genders, and emotional neglect was also a factor for men. Population attributable risk fractions for sexual abuse were 25.75% for women and 8.56% for men. Sexual abuse and a higher number of ACEs were also related to repeated suicide attempts. A higher number of ACEs was associated with a younger first attempt age. Gay/bisexual orientation in men and the lack of college education in both genders were significant covariates. In conclusion, this study underscores that ACEs are significantly associated with lifetime suicide attempts even when mental and substance use disorders are controlled.  相似文献   

5.
Shaking and smothering in response to infant crying are life-threatening child abuse. Parental childhood abuse history is known to be one of the most robust risk factors for abusing their offspring. In addition to childhood abuse history, other adverse childhood exposures (ACEs) need to be considered due to co-occurrence. However, few studies have investigated the impact of ACEs on caregivers shaking and smothering their infant. This study aims to investigate the association of ACEs with shaking and smothering among caregivers of infants in Japan. A questionnaire was administered to caregivers participating in a four-month health checkup between September 2013 and August 2014 in Chiba City, Japan, to assess their ACEs (parental death, parental divorce, mentally ill parents, witness of intimate partner violence, physical abuse, neglect, psychological abuse and economic hardship), and shaking and smothering toward their infants (N = 4297). Logistic regression analysis was used to examine the cumulative and individual impacts of ACEs on shaking and smothering. Analyses were conducted in 2015. A total of 28.3% reported having experienced at least one ACE during their childhood. We found that only witness of IPV had a significant association with shaking of infant (OR = 1.93, 95% CI: 1.03–3.61). The total number of ACEs was not associated with either shaking or smothering. Our findings suggest that shaking and smothering in response to crying can occur regardless of ACEs. Population-based strategies that target all caregivers to prevent shaking and smothering of infants are needed.  相似文献   

6.
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7.
OBJECTIVE: This study is a detailed examination of the association between parental alcohol abuse (mother only, father only, or both parents) and multiple forms of childhood abuse, neglect, and other household dysfunction, known as adverse childhood experiences (ACEs). METHOD: A questionnaire about ACEs including child abuse, neglect, household dysfunction, and exposure to parental alcohol abuse was completed by 8629 adult HMO members to retrospectively assess the relationship of growing up with parental alcohol abuse to 10 ACEs and multiple ACEs (ACE score). RESULTS: Compared to persons who grew up with no parental alcohol abuse, the adjusted odds ratio for each category of ACE was approximately 2 to 13 times higher if either the mother, father, or both parents abused alcohol (p < 0.05). For example, the likelihood of having a battered mother was increased 13-fold for men who grew up with both parents who abused alcohol (OR, 12.7; 95% CI: 8.4-19.1). For almost every ACE, those who grew up with both an alcohol-abusing mother and father had the highest likelihood of ACEs. The mean number of ACEs for persons with no parental alcohol abuse, father only, mother only, or both parents was 1.4, 2.6, 3.2, and 3.8, respectively (p < .001). CONCLUSION: Although the retrospective reporting of these experiences cannot establish a causal association with certainty, exposure to parental alcohol abuse is highly associated with experiencing adverse childhood experiences. Improved coordination of adult and pediatric health care along with related social and substance abuse services may lead to earlier recognition, treatment, and prevention of both adult alcohol abuse and adverse childhood experiences, reducing the negative sequelae of ACEs in adolescents and adults.  相似文献   

8.
OBJECTIVE: Childhood abuse and other adverse childhood experiences (ACEs) have historically been studied individually, and relatively little is known about the co-occurrence of these events. The purpose of this study is to examine the degree to which ACEs co-occur as well as the nature of their co-occurrence. METHOD: We used data from 8,629 adult members of a health plan who completed a survey about 10 ACEs which included: childhood abuse (emotional, physical, and sexual), neglect (emotional and physical), witnessing domestic violence, parental marital discord, and living with substance abusing, mentally ill, or criminal household members. The bivariate relationship between each of these 10 ACEs was assessed, and multivariate linear regression models were used to describe the interrelatedness of ACEs after adjusting for demographic factors. RESULTS: Two-thirds of participants reported at least one ACE; 81%-98% of respondents who had experienced one ACE reported at least one additional ACE (median: 87%). The presence of one ACE significantly increased the prevalence of having additional ACEs, elevating the adjusted odds by 2 to 17.7 times (median: 2.8). The observed number of respondents with high ACE scores was notably higher than the expected number under the assumption of independence of ACEs (p <.0001), confirming the statistical interrelatedness of ACEs. CONCLUSIONS: The study provides strong evidence that ACEs are interrelated rather than occurring independently. Therefore, collecting information about exposure to other ACEs is advisable for studies that focus on the consequences of a specific ACE. Assessment of multiple ACEs allows for the potential assessment of a graded relationship between these childhood exposures and health and social outcomes.  相似文献   

9.
This pilot study examined the psychometric properties of the Benevolent Childhood Experiences (BCEs) scale, a new instrument designed to assess positive early life experiences in adults with histories of childhood maltreatment and other adversities. A counterpart to the Adverse Childhood Experiences (ACEs) questionnaire, the BCEs was developed to be multiculturally-sensitive and applicable regardless of socioeconomic position, urban-rural background, or immigration status. Higher levels of BCEs were hypothesized to predict lower levels of psychopathology and stress beyond the effects of ACES in a sample of ethnically diverse, low-income pregnant women. BCEs were also expected to show adequate internal validity across racial/ethnic groups and test-retest stability from the prenatal to the postnatal period. Participants were 101 pregnant women (M = 29.10 years, SD = 6.56, range = 18–44; 37% Latina, 22% African-American, 20% White, 21% biracial/multiracial/other; 37% foreign-born, 26% Spanish-speaking) who completed the BCEs and ACEs scales; assessments of prenatal depression and post-traumatic stress disorder (PTSD) symptoms, perceived stress, and exposure to stressful life events (SLEs) during pregnancy; and demographic information. Higher levels of BCEs predicted less PTSD symptoms and SLEs, above and beyond ACEs. The BCEs showed excellent test-retest reliability, and mean levels were comparable across racial/ethnic and Spanish-English groups of women. Person-oriented analyses also showed that higher levels of BCEs offset the effects of ACEs on prenatal stress and psychopathology. The BCEs scale indexes promising promotive factors associated with lower trauma-related symptomatology and stress exposure during pregnancy and illuminates how favorable childhood experiences may counteract long-term effects of childhood adversity.  相似文献   

10.
OBJECTIVE: This study assesses the relationship of childhood sexual abuse (CSA) to nine other categories of Adverse Childhood Experiences (ACEs), including childhood abuse, neglect, and multiple types of household dysfunction. METHODS: Retrospective cohort study data were collected from 17,337 adult health plan members who responded to a survey questionnaire. Regression models adjusted for age, race, and education were used to estimate the strength of the association of CSA to each of the other nine ACEs and a graded relationship between measures of the severity of CSA and the number of other ACEs (ACE score). RESULTS: CSA was reported by 25% of women and 16% of men. In comparison with persons who were not exposed to CSA, the likelihood of experiencing each category of ACE increased 2- to 3.4-fold for women and 1.6- to 2.5-fold for men (p < 0.05). The adjusted mean ACE score showed a significant positive graded relationship to the severity, duration, and frequency of CSA and an inverse relationship to age at first occurrence of CSA (p < 0.01). CONCLUSIONS: CSA is strongly associated with experiencing multiple other forms of ACEs. The strength of this association appears to increase as the measures of severity of the CSA increases. The understanding of the interrelatedness of CSA with multiple ACEs should be considered in the design of studies, treatment, and programs to prevent CSA as well as other forms of ACEs.  相似文献   

11.
《Child abuse & neglect》2014,38(12):2007-2020
The relation between childhood sexual abuse (CSA) and physical health disorders in adulthood, and what factors may serve as mediators, remains poorly understood. Using data from the 2007 Adult Psychiatric Morbidity Survey (N = 3,486), we tested whether CSA was associated with physical health disorders in adult women and if mediated effects via body mass index (BMI), anxiety/depression, alcohol dependence, and smoking were present. Compared to women with no CSA, women who had experienced CSA involving intercourse had more than twice the odds of being obese, more than 3 times the odds of experiencing mental health disorders, more than 4 times the odds of being alcohol dependent, more than 5 times the odds of being drug dependent, and more than 6 times the odds of attempting suicide. Those experiencing both CSA and child physical abuse (CPA) were on average over 11 kg heavier than those with neither CSA nor CPA. After controlling for demographics, CPA, and childhood bullying, CSA was associated with the majority of physical health disorders studied (typically 50–100% increases in odds). Evidence was found consistent with mediation by BMI (typically accounting for 5–20% increases in odds) and anxiety/depression (typically accounting for 8–40% increases in odds), in a dose-response manner, for the majority of physical health disorders. Bidirectional relations among these mediators and physical health disorders, and residual confounding, may have led to overestimation of mediation through BMI and anxiety/depression and underestimation of mediation through alcohol/smoking. Relations between both CPA and childhood bullying and physical health disorders in adulthood were also found. Longitudinal studies employing more sensitive measures of potential mediators are now required.  相似文献   

12.
Despite great interest in adverse childhood experiences (ACEs), there has been limited research on racial and ethnic differences in their prevalence. Prior research in the United States suggests that the prevalence of ACEs varies along socioeconomic lines, but it is uncertain whether there are racial/ethnic differences in ACE rates among low-income populations. This study examined the distribution of ACEs in a sample of 1523 low-income women in Wisconsin that received home visiting services. Participants ranging in age from 16 to 50 years were coded into five racial/ethnic groups, including Hispanics and four non-Hispanic groups: blacks, whites, American Indians, and other race. Following measurement conventions, ten dichotomous indicators of child maltreatment and household dysfunction were used to create a composite ACE score. Five other potential childhood adversities were also assessed: food insecurity, homelessness, prolonged parental absence, peer victimization, and violent crime victimization. Results from bivariate and multivariate analyses revealed that, while rates of adversity were high overall, there were significant racial/ethnic differences. Total ACE scores of American Indians were comparable to the ACE scores of non-Hispanic whites, which were significantly higher than the ACE scores of non-Hispanic blacks and Hispanics. Whites were more likely than blacks to report any abuse or neglect, and they were more likely than blacks and Hispanics to report any household dysfunction. The results underscore the need to account for socioeconomic differences when making racial/ethnic comparisons. Potential explanations for the observed differences are examined.  相似文献   

13.
Adverse childhood experiences (ACEs) have lifetime consequences for health and development. Identification of ACEs early in childhood provides the potential to intervene before health and development are impaired. This study examined the timing and duration of exposure to ACEs experienced by children from low-income families from ages one to three years to identify whether there were patterns of exposure when infants and toddlers were most vulnerable. We were able to confirm the early negative consequences on cognitive, health, and behavior outcomes previously reported in young children using a national, longitudinal data set of parents and children from low-income households (N = 2250). Using Finite Mixture Models, five classes of exposure were identified for children, Consistently Low (63.8%), Decreasing (10.3%), High at Age 2 (11.4%), Increasing (10.4%), and Consistently High (4%). The Consistently Low and Consistently High classes had the most and least optimal development across all domains, respectively. When examining child development outcomes among children with variable exposures to adversities, we found that for cognitive, language, and physical development, the most proximal ACEs were more robust for predicting child outcomes. For socioemotional health, exposure at any time from one to three to ACEs had negative consequences. As a whole, findings from this study highlight the need to consider ACEs screening tools that are both time-sensitive and permit a lifetime report.  相似文献   

14.
BackgroundAlthough adverse childhood experiences (ACEs) are relatively common among children, there is limited knowledge on the co-occurrence of such experiences.ObjectiveThe current study therefore investigates co-occurrence of childhood adversity in the Netherlands and whether specific clusters are more common among certain types of families.Participants and SettingRepresentative data from the Family Survey Dutch population 2018 (N = 3,128) are employed.MethodWe estimate Latent Class Analysis (LCA) models to investigate co-occurrence of ACEs. As ACEs we examine maltreatment, household dysfunction, demographic family events, as well as financial and chronic health problems. Gradual measures for maltreatment and financial problems are studied to make it possible to differentiate with regard to the severity of experiences.ResultsOur results show that four ACE clusters may be identified: ‘Low ACE’, ‘Moderate ACE: Household dysfunction’, ‘Moderate ACE: Maltreatment’ and ‘High ACE’. Regression analyses indicated that mother’s age at first childbirth and the number of siblings were related to experiencing childhood adversity. We found limited evidence for ACEs to be related to a family’s socioeconomic position.ConclusionThe found clusters of ACEs reflect severity of childhood adversity, but also the types of adversity a child experienced. For screening and prevention of childhood adversity as well as research on its consequences, it is relevant to acknowledge this co-occurrence of types and severity of adversity.  相似文献   

15.
The general aim of early intervention and home visiting programs is to support families to minimize Adverse Childhood Experiences (ACEs). However, assessing children's exposure to these risks is complicated because parents serve as the conduit for both measurement and intervention. The primary aims of the study were to develop an assessment of children's exposure to ACEs and to examine concurrently measured parental child abuse and neglect potential and child social–emotional functioning. Home visiting programs in a southern state implemented the Family Map Inventories (FMI) as comprehensive family assessment and child screenings (N = 1,282) within one month of enrollment. Children (M = 33 months of age, SD = 20) were exposed at rates of 27% to one, 18% to two, 11% to three, and 12% to four or more FMI-ACEs. FMI-ACEs were associated with increased parental beliefs and behaviors associated with child abuse and neglect. FMI-ACEs also significantly predicted the likelihood of the child having at-risk social–emotional development; children with 4 or more FMI-ACEs were over 6 times more likely than those with none to have at-risk scores. The findings add to our understanding of the negative impact of trauma on children and families. Assessing these risks as they occur in a family-friendly manner provides a platform for early intervention programs to work with families to increase family strengths and reduce the impacts of adverse experiences for their children.  相似文献   

16.
Although many children with reading difficulty (RD) are reported to struggle with mathematics, little research has empirically investigated whether this is the case for different types of RD. This study examined the mathematics skills of third graders with one of two types of RD: dyslexia (n = 18) or specific reading comprehension difficulty (n = 22), as contrasted to a comparison group (n = 247). Children's performance on arithmetic fact fluency, operations, and applied problems was assessed using standardized measures. The results indicated that children with dyslexia experienced particular difficulty with arithmetic fact fluency and operations: they were 5.60 times and 8.54 times more likely than other children to experience deficits in fact fluency and operations, respectively. Our findings related to arithmetic fact fluency were more consistent with domain-general explanations of the co-morbidity between RD and mathematics difficulty, whereas our findings related to operations were more consistent with domain-specific accounts.  相似文献   

17.
Research has demonstrated the negative impact of Adverse Childhood Experiences (ACEs) on long-term trajectories of mental and physical health. Yet existing literature on this topic is limited in its understanding of outcomes among youth samples, optimal measurement items and methods, and differences in adverse experiences across race/ethnicity. The current study used a person-centered approach to measure ACEs and their impact on youth health outcomes across three different racial/ethnic groups from a large national database. Patterns of exposure to adverse experiences among Black, Latinx, and White youth (N = 30,668, ages 12–17) were determined empirically using latent class analysis (LCA). Significant differences in class membership by demographic indicators (age, household income, sex) and concurrent health outcomes were identified. Different models emerged for Black (2 classes), Latinx (3 classes), and White youth (3 classes). Older and lower-income youth were more likely to have experienced adversities, but there were no differences in adversity likelihood by sex. Additionally, racial/ethnic minority youth were at greater risk of experiencing higher levels of adversity, poverty, and poor health when compared to their White counterparts. Rather than occuring in meaningful clusters, adverse experiences among youth reflected a cumulative risk model such that classes were defined by the overall intensity of adverse experiences (i.e., low, moderate, high). Findings provide greater knowledge regarding the relationship between ACEs and health and future research directions to inform more targeted and culturally-appropriate screening, prevention, and intervention programs.  相似文献   

18.
Adverse Childhood Experiences (ACEs) have been associated with an increased risk of a variety of diseases, including cancer. However, research has not paid enough attention to the association between ACEs and cancer screening. As such, the present study examined the association between ACEs and ever using colorectal cancer (CRC) screening, among adults age 50 and over. Analyses used the 2011 Behavioral Risk Factor Surveillance System (n = 24,938) to model odds of ever engaging in CRC screening from nine different adversities. Bivariate and multivariate models were fit. In bivariate models, physical abuse, having parents that were divorced or separated, and living in a household where adults treated each other violently were associated with lower odds of engaging in CRC. In multivariate models that accounted for potential confounders, emotional and sexual abuse were each associated with higher odds of engaging in CRC. Results suggest potential pathways by which early childhood experiences can impact future health behaviors. Future research should examine this association longitudinally.  相似文献   

19.
《Child abuse & neglect》2014,38(9):1540-1551
The aim of this study was to describe contextual events, abuse experiences, and disclosure processes of adolescents who presented to a hospital-based Child Advocacy Center for medical evaluation and evidentiary collection as indicated after experiencing multiple perpetrator rape during a single event (n = 32) and to compare these findings to a group of single perpetrator sexual assaults (n = 534). This study used a retrospective mixed-methods design with in-depth, forensic interviews and complete physical examinations of gang-raped adolescents. Patients ranged from 12 to 17 years (M = 14 years). Girls who experienced multiple perpetrator rape during a single event were more likely to have run away, to have drunk alcohol in the past month, and to have participated in binge drinking in the past 2 weeks. Acute presentation of these victims were rare but 30% had hymenal transections and 38% had sexually transmitted infections (STIs). Forensic interviews revealed alcohol was a common weapon used by offenders, and its use resulted in victims experiencing difficulty in remembering and reporting details for police investigation or physical and mental health care. Most victims were raped at parties they attended with people they thought they could trust, and they felt let down by witnesses who could have helped but did not intervene. Although relatively rare, multiple perpetrator rape during a single event is a type of severe sexual assault experience and has significant risks for deleterious health outcomes. These victims require health care by trained providers to diagnose physical findings, treat STIs, screen for trauma, and support victims.  相似文献   

20.
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 <.0001). After adjustment for age, sex, race/ethnicity, and education, adults with an ACE score >or=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.  相似文献   

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