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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.
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
3.
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
4.
Responses from N = 60,598 interviews from the 2010 Behavioral Risk Factor Surveillance System (the 10 states and the District of Columbia that included the optional Adverse Childhood Experience (ACE) module) were used to test whether associations between childhood adversity and adult mental health and alcohol behaviors vary by race/ethnicity and sex. ACE items were categorized into two types – household challenges and child abuse. Outcomes were current depression, diagnosed depression, heavy drinking and binge drinking. Logistic regression models found ACEs significantly associated with depression and excessive alcohol use, but sex did not moderate any relationships. Race/ethnicity moderated the relationship between ACEs and heavy drinking. In stratified analyses, compared to those not exposed to ACEs, non-Hispanic blacks who experienced either type of ACE were about 3 times as likely to drink heavily; Non-Hispanic whites who experienced child abuse or both ACE types were 1.5–2 times as likely to drink heavily; and Hispanics who experienced household challenges or both ACE types were 1.2 and 11 times as likely to report heavy drinking. ACEs impact depression and excessive alcohol use similarly across men and women. With the exception of heavy drinking, ACEs appear to have the same association with excessive alcohol use across race/ethnicity. It may be prudent to further investigate why the relationship between ACEs and heavy drinking may differ by race/ethnicity such that prevention strategies can be developed or refined to effectively address the needs of all sub-groups. 相似文献
5.
Anne Murphy Miriam Steele Shanta Rishi Dube Jordan Bate Karen Bonuck Paul Meissner Hannah Goldman Howard Steele 《Child abuse & neglect》2014
Although Adverse Childhood Experiences (ACEs) are linked to increased health problems and risk behaviors in adulthood, there are no studies on the association between ACEs and adults’ states of mind regarding their early childhood attachments, loss, and trauma experiences. To validate the ACEs questions, we analyzed the association between ACEs and emotional support indicators and Adult Attachment Interview (AAI) classifications in terms of unresolved mourning regarding past loss or trauma and discordant states of mind in cannot classify (U/CC) interviews. Seventy-five urban women (41 clinical and 34 community) completed a questionnaire on ACEs, which included 10 categories of abuse, neglect, and household dysfunction, in addition to emotional support. Internal psychological processes or states of mind concerning attachment were assessed using the AAI. ACE responses were internally consistent (Cronbach's α = .88). In the clinical sample, 84% reported ≥ 4 ACEs compared to 27% among the community sample. AAIs judged U/CC occurred in 76% of the clinical sample compared to 9% in the community sample. When ACEs were ≥ 4, 65% of AAIs were classified U/CC. Absence of emotional support in the ACEs questionnaire was associated with 72% of AAIs being classified U/CC. As the number of ACEs and the lack of emotional support increases so too does the probability of AAIs being classified as U/CC. Findings provide rationale for including ACEs questions in pediatric screening protocols to identify and offer treatment reducing the intergenerational transmission of risk associated with problematic parenting. 相似文献
6.
Very little research has been conducted on the role of childhood adversity in child-to-parent violence. Childhood adversity places youth at risk for internalizing behaviors (i.e. anxiety and depression) and externalizing behaviors (i.e. aggression). The purpose of this study was to explore the relationships between childhood adversity, child–mother attachment, and internalizing behaviors among a sample of 80 youth who have been arrested for domestic battery against a mother. This study reported high prevalence rates of childhood adversity (mean score of 10 out of 17 events). Multiple regression analysis indicated that insecure attachment predicted depression among females (F(6, 73) = 4.87, p < 0.001), and previous experience with child maltreatment and/or witness to parental violence predicted anxiety among females (F(6, 73) = 3.08, p < 0.01). This study is the first study to explore childhood adversity among a sample of perpetrators of child-to-mother violence and notably adds to our understanding of the multiple pathways connecting childhood adversity, child–mother attachment, and depression and anxiety among a difficult to treat youth population. 相似文献
7.
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
8.
《Child abuse & neglect》2014,38(10):1581-1589
The purpose of the present study was to examine the prevalence of child maltreatment and lifetime exposure to other traumatic events in a sample of deaf and hard of hearing (DHH; n = 147) and matched hearing (H; n = 317) college students. Participants completed measures of child maltreatment (CM), adult victimization and trauma exposure, and current symptoms of posttraumatic stress disorder (PTSD). Overall, DHH participants reported significantly more instances of CM compared to H participants, with 76% of DHH reporting some type of childhood abuse or neglect. Additionally, DHH participants reported experiencing a higher number of different types of CM, and also reported increased incidents of lifetime trauma exposure and elevated PTSD symptoms. Severity of deafness increased the risk of maltreatment, with deaf participants reporting more instances of CM than hard of hearing participants, and hard of hearing participants reporting more instances of CM than H participants. Among DHH participants, having a deaf sibling was associated with reduced risk for victimization, and identification with the Deaf community was associated with fewer current symptoms of PTSD. A regression model including measures of childhood physical and sexual abuse significantly predicted adult re-victimization and accounted for 27% of the variance among DHH participants. DHH participants report significantly higher rates of CM, lifetime trauma, and PTSD symptoms compared to H participants. Severity of deafness appears to increase the risk of being victimized. Being part of the Deaf community and having access to others who are deaf appear to be important protective factors for psychological well-being among DHH individuals. 相似文献
9.
Growing evidence suggests that toxic stressors early in life not only convey developmental impacts but also augment risk of proliferating chains of additional stressors that can overwhelm individual coping and undermine recovery and health. Examining trauma within a life course stress process perspective, we posit that early childhood adversity carries a unique capacity to impair adult psychological well-being both independent of and cumulative with other contributors, including social disadvantage and stressful adult experiences. This study uses data from a representative population-based health survey (N = 13,593) to provide one of the first multivariate assessments of unique, cumulative, and moderated effects of adverse childhood experiences (ACEs) toward explaining 3 related yet distinct measures of adult mental health: perceived well-being, psychological distress, and impaired daily activities. Results demonstrate support for each set of hypothesized associations, including exacerbation and amelioration of ACEs effects by adult stress and resilience resources, respectively. Implications for services and future research are discussed. 相似文献
10.
Many children involved with the child welfare system witness parental domestic violence. The association between children's domestic violence exposure and child welfare involvement may be influenced by certain socio-cultural factors; however, minimal research has examined this relationship. The current study compares domestic violence experiences and case outcomes among Latinas who are legal immigrants (n = 39), unauthorized immigrants (n = 77), naturalized citizens (n = 30), and US-born citizen mothers (n = 383) reported for child maltreatment. This analysis used data from the second round of the National Survey of Child and Adolescent Well-being. Mothers were asked about whether they experienced domestic violence during the past year. In addition, data were collected to assess if (a) domestic violence was the primary abuse type reported and, if so, (b) the maltreatment allegation was substantiated. Results show that naturalized citizens, legal residents, and unauthorized immigrants did not differ from US-born citizens in self-reports of domestic violence; approximately 33% of mothers reported experiences of domestic violence within the past year. Yet, unauthorized immigrants were 3.76 times more likely than US-born citizens to have cases with allegations of domestic violence as the primary abuse type. Despite higher rates of alleged domestic violence, unauthorized citizens were not more likely than US-born citizens to have these cases substantiated for domestic violence (F(2.26, 153.99) = 0.709, p = .510). Findings highlight that domestic violence is not accurately accounted for in families with unauthorized immigrant mothers. We recommend child welfare workers are trained to properly assess and fulfill the needs of immigrant families, particularly as it relates to domestic violence. 相似文献
11.
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
12.
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
13.
14.
Prevention programs often encourage sexually abused children to disclose without fully considering the potential for adverse consequences. This study examined the impact of disclosure on abuse cessation and later adult symptomatology. A clinical sample of 301 adult survivors completed the Impact of Event Scale (IES/IES-R), and the Beck Depression Inventory (BDI-II). Participants were divided into 3 groups: Nondisclosure (n = 221), Disclosure/Abuse Ended (n = 25), and Disclosure/Abuse Continued (n = 55). Multivariate analyses of covariance, adjusting for abuse characteristics (age of onset, penetration, and number of perpetrators) and other trauma exposure, revealed significant differences in psychiatric symptom severity among the three groups, Wilks’ λ = 0. 95, F (6, 584) = 2.69, p = 0.014, ηp2 = 0.03. Specifically, those in the Disclosure/Abuse Continued group scored significantly higher on the IES/IES-R Intrusion subscale (p = 0.04) and the BDI-II (p = 0.01), as compared to the Nondisclosure group. The Disclosure/Abuse Ended group did not differ significantly from the other groups. Results suggest that disclosure may be detrimental unless adequate steps are taken to ensure abuse cessation and appropriate treatment. 相似文献
15.
Yuliya Ardasheva Sze Sze Tong Thomas R. Tretter 《Learning and individual differences》2012,22(4):473-483
This study modified and validated a measure of motivational orientations – grounded in self-determination theory and originally developed for postsecondary students – for use with younger (pre-college) English language learners (ELLs). Exploratory factor analysis results in Sample A (n = 528) indicated that the data were best explained by a three-factor solution (intrinsic motivation, introjected regulation, and external regulation) that explained 51.6% of the variance. These results were corroborated by a confirmatory factor analysis in an independent Sample B (n = 529; GFI = .97, CFI = .96, SRMR = .04, RMSEA = .05). The test for invariance across the two samples further supported the validity of the measure. The modified instrument, named English Language Learner Motivation Scale (ELLMS): Pre-College, showed strong psychometric characteristics for use with elementary (ages 9–11 years), middle (ages 12–14 years), and high school (ages 16–17) ELLs. Applications of the measure are discussed. 相似文献
16.
BackgroundAcquiring more complex coping strategies despite a history of childhood adversity may transpire in settings outside the family home.ObjectivesThe objectives of this cross-sectional study included investigating coping strategies under stressful situations in a non-clinical sample of active athletes and performing artists. Participants and Setting: In this community and university sample (n = 577), 40.4% had no ACEs, 43.4% had 1–3 ACEs, and 16.3% had ≥4 ACEs.MethodsA series of multivariate analyses (gender and age included as covariates) were conducted to examine differences between the three ACE groups.ResultsResults indicated no between-subject differences between the three ACE groups for flow-like experiences during preferred activities, although gender differences were significant (p < .001). Individuals in the ≥4 ACEs group endorsed more intense creative experiences compared to the no-ACE and 1–3 ACEs groups (p = .006, η2 = .048); however, in the third MANCOVA they had heightened anxiety, internalized shame, dissociative processing, emotion-oriented coping, and cumulative trauma (p < .001, η2 = .132). There were no group differences for task-oriented and avoidant-oriented coping, a finding that highlights the ability of active individuals to engage in effective coping strategies under stressful situations.ConclusionRegardless of past childhood adversity history, this non-clinical high achieving sample was able to engage in a range of coping strategies under stress. 相似文献
17.
ObjectiveThe sexually abused–sexual abuser hypothesis states there is a specific relationship between sexual abuse history and sexual offending, such that individuals who experience sexual abuse are significantly more likely to later engage in sexual offenses. Therefore, samples of adult sex offenders should contain a disproportionate number of individuals who have experienced sexual abuse, but not necessarily other types of abuse, compared with samples of other types of offenders.MethodsWe compared rates of sexual and other forms of abuse reported in 17 studies, involving 1,037 sex offenders and 1,762 non-sex offenders. We also examined the prevalence of different forms of abuse in 15 studies that compared adult sex offenders against adults (n = 962) and against children (n = 1,334), to determine if the sexually abused–sexual abuser association is even more specific to individuals who sexually offend against children.ResultsWe observed a higher prevalence of sexual abuse history among adult sex offenders than among non-sex offenders (Odds Ratio = 3.36, 95% confidence intervals of 2.23–4.82). The two groups did not significantly differ with regard to physical abuse history (OR = 1.50, 95% CI = 0.88–2.56). There was a significantly lower prevalence of sexual abuse history among sex offenders against adults compared to sex offenders against children (OR = 0.51, 95% CI = 0.35–0.74), whereas the opposite was found for physical abuse (OR = 1.43, 95% CI = 1.02–2.02).ConclusionThere is support for the sexually abused–sexual abuser hypothesis, in that sex offenders are more likely to have been sexually abused than non-sex offenders, but not more likely to have been physically abused. We discuss potential mechanisms for the relationship between sexual abuse history and sexual offending, including the possibility that a third factor might account for the relationship.Practice implicationsThe most obvious implications of these findings is that the prevention of sexual abuse of children, either through prevention programs directly targeting children or through treatment programs targeting individuals who are likely to sexually offend against children (e.g., known sex offenders against extra-familial boys), may eventually reduce the number of sex offenders. This implication is dependent, however, on a causal role of childhood sexual abuse, and on the effectiveness of prevention and treatment practices. 相似文献
18.
To determine whether different types of childhood adversity are associated with body mass index (BMI) in adolescence, we studied 147 adolescents aged 13–17 years, 41% of whom reported exposure to at least one adversity (maltreatment, abuse, peer victimization, or witness to community or domestic violence). We examined associations between adversity type and age- and sex-specific BMI z-scores using linear regression and overweight and obese status using logistic regression. We adjusted for potential socio-demographic, behavioral, and psychological confounders and tested for effect modification by gender. Adolescents with a history of sexual abuse, emotional abuse, or peer victimization did not have significantly different BMI z-scores than those without exposure (p > 0.05 for all comparisons). BMI z-scores were higher in adolescents who had experienced physical abuse (β = 0.50, 95% CI 0.12–0.91) or witnessed domestic violence (β = 0.85, 95% CI 0.30–1.40). Participants who witnessed domestic violence had almost 6 times the odds of being overweight or obese (95% CI: 1.09–30.7), even after adjustment for potential confounders. No gender-by-adversity interactions were found. Exposure to violence in childhood is associated with higher adolescent BMI. This finding highlights the importance of screening for violence in pediatric practice and providing obesity prevention counseling for youth. 相似文献
19.
In this article we review the literature on attachment patterns in institutionalized children and then perform a meta-analysis on data from 10 attachment studies involving 399 children in institutional settings. We computed the overall attachment distribution of secure, insecure, and disorganized rates and explored the effect of a set of moderating variables (i.e., country of institutionalization, attachment assessment procedure, age at entry, and age at assessment). To overcome bias related to the small number of studies, we conducted both classical and Bayesian meta-analysis and obtained comparable results. Distribution of children's attachment patterns was: 18% secure, 28% insecure, and 54% disorganized/cannot classify. Compared to their family-reared peers, children living in an institution were found to be at greater risk for insecure and disorganized attachment, with a similar medium effect size for both distributions (d = 0.77 and d = 0.76, respectively). The following moderating variables were associated with insecure attachment: representational assessment procedures (d = 0.63) and Eastern European countries of origin (d = 1.13). Moderators for disorganized attachment were: Eastern European countries of origin (d = 1.12), age at institution entry before the first birthday (d = 0.93), and age at assessment under three years of age (d = 0.91). Implications for child development and policies are discussed. 相似文献
20.
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