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1.
Repeated exposure to childhood adversity (abuse, neglect and other traumas experienced before age 18) can have lifelong impacts on health. For HIV-infected adolescents and youth, such impacts may include onward transmission of HIV. To evaluate this possibility, the current study measured the burden of childhood adversity and its influence on risky health behaviors among perinatally-infected adolescents and youth. We surveyed 250 perinatally-infected adolescents and youth (13–24 years) receiving care in Soweto, South Africa. Both male and female participants reported on childhood adversity (using the ACE-IQ), sexual behavior, and psychosocial state. Viral load was also abstracted from their charts. We used logistic regressions to test the association between cumulative adversity and behavioral outcomes. Half the sample reported eight or more adversities. Overall, 72% experienced emotional abuse, 59% experienced physical abuse, 34% experienced sexual abuse, 82% witnessed domestic violence, and 91% saw someone being attacked in their community. A clear gradient emerged between cumulative adversities and behavioral risk. Having experienced one additional childhood adversity raised the odds of risky sexual behavior by almost 30% (OR 1.27, 95% CI 1.09–1.48). Viral suppression was poor overall (31% had viral loads >400 copies/ml), but was not related to adversity. Adversity showed a robust relationship to depression and substance abuse. Childhood adversity is common, influences the current health of HIV-positive adolescents and youth, and puts their sexual partners at risk for HIV infection. Greater primary prevention of childhood adversity and increased access to support services (e.g., mental health) could reduce risk taking among HIV-positive adolescents and youth.  相似文献   

2.
BackgroundAlthough most children experience at least one adversity, it is the experience of multiple adversities that produces a context of disadvantage that increases the risk of various negative outcomes in adulthood. Previous measures of cumulative childhood adversity consider a limited number of adversities, overlook potential differences across experiences of adversity, and fail to measure the effects of multiple co-occurring childhood adversities. These limitations have led to inconsistent and incomplete conclusions regarding the impact of multiple adverse childhood experiences on adult mental health.ObjectiveThis study assesses how the operationalization and modeling of exposure to cumulative childhood adversity (CCA) influences estimates of the association between CCA and adult psychological distress and develops an improved measure of CCA.MethodsWe use data from the Panel Study of Income Dynamics, a nationally representative sample of households in the United States, and its supplement, the Childhood Retrospective Circumstances Study (N = 4219). We compare four measures of CCA that consider various distinct aspects of adverse experiences (additive, severity, type, and patterns of experience using latent class analysis).ResultsAll measures of CCA were associated with increases in adult psychological distress, but effects depend on the measurement of CCA. Results suggest the sum score overestimates the overall impact of CCA. Latent class analysis captures the co-occurrence of adversities across severity and type, providing an improved measure of CCA.ConclusionsThe heterogeneity across adversities impacts estimates of adult psychological distress. Measuring CCA as patterns of co-occurring adverse experiences is a promising approach.  相似文献   

3.
BackgroundA history of childhood abuse and neglect (CAN) is associated with exposure to later negative life events. CAN at an early age, multiple cooccurring exposures (cumulative events), and a high severity and frequency of exposure have potential detrimental long-term effects.ObjectiveThe present study examines the relationship between the severity of CAN and the prevalence of school difficulties and hardship at school, adult adversity and mental health.Participants and Settings: Participants were recruited from in- and outpatient mental health or substance abuse treatment facilities, child protective services (CPS), and prisons (N = 809, age range = 13–66, mean age = 27.62, SD = 10.47).MethodsExposure to childhood maltreatment was assessed by the Childhood Trauma Questionnaire Short Form (CTQ-SF). After adjusting for gender and age, we conducted a risk ratio regression analysis to investigate associations between severity of child abuse and neglect and hardship at school, adult adversity and adult mental health.ResultsThe moderate and severe level groups of CAN had statistically significant higher risk ratios for experiences of school difficulties, hardship at school, adult adversity and mental health problems. A robust dose-response was found between severity levels.ConclusionAt an individual level the findings highlight the association between exposure to abuse and adult adversity, underscoring the importance of targeting individuals with high risk of exposure to CAN to reduce the negative long-term risk for Polyvictimization.  相似文献   

4.
ObjectiveTo investigate the joint effect of child abuse and neglect (CAN) and community violence (CV) on adolescents with peers that commit youth violence (YV).MethodsThis is a school-based cross-sectional study of 699 students enrolled in four public and nine private schools in the municipality of Rio de Janeiro, Brazil. Participants were selected through a complex cluster sampling procedure. CAN was identified using the Childhood Trauma Questionnaire (CTQ). Exposure to CV was assessed by asking students if they have witnessed cases of lethal violence in the community. YV was measured indirectly through questions about having friends who have committed acts of crime. Multivariate logistic models were used to study the effects of emotional, physical, and sexual abuse and emotional and physical neglect in childhood on YV, controlled for confounders, according to different levels of CV.ResultsEmotional abuse OR = 3.32 (CI 95%: 1.79–6.17), sexual abuse OR = 2.33 (CI 95%: 1.20–4.54), and physical neglect OR = 1.81 (CI 95%: 1.02–3.20) increased the odds of YV in adolescents, whether cooccurring with CV or not. Physical abuse OR = 3.95 (CI 95%: 2.29 - 6.80) and emotional neglect OR = 2.93 (CI 95%: 1.83–4.72) are only risk factors for YV involvement when associated with CV.ConclusionsThese findings highlight the relevance of CAN and CV as risk factors for YV and the potential increase in adolescents’ vulnerability when exposed to both. Policies aiming at preventing and dealing with CAN are essential strategies to reduce YV, especially in areas with high levels of CV.  相似文献   

5.
IntroductionCoerced and forced sexual initiation (FSI) can have detrimental effects on children and youth. Understanding health outcomes that are associated with experiences of FSI is important for developing appropriate strategies for prevention and treatment of FSI and its consequences.MethodsThe Violence Against Children Surveys were conducted in Nigeria, Uganda, and Zambia in 2014 and 2015. We examined the prevalence of FSI and its consequences (sexual high-risk behaviors, violence experiences, mental health outcomes, and sexually transmitted infections (STI)) associated with FSI among youth aged 13–24 years in three countries in sub-Saharan Africa.ResultsOver one in ten youth aged 13–24 years who had ever had sex experienced FSI in Nigeria, Uganda, and Zambia. In multivariable logistic regression, FSI was significantly associated with infrequent condom use (OR = 1.4, 95%CI = 1.1–2.1), recent experiences of sexual violence (OR = 1.6, 95%CI: 1.1–2.3), physical violence (OR = 2.2, 95%CI: 1.6–3.0), and emotional violence (OR = 2.0, 95%CI: 1.3–2.9), moderate/serious mental distress (OR = 1.5, 95%CI: 1.1–2.0), hurting oneself (OR = 2.0, 95%CI: 1.3–3.1), and thoughts of suicide (OR = 1.5, 95%CI: 1.1–2.3), after controlling for demographic characteristics. FSI was not statistically associated with engaging in transactional sex, having multiple sex partners, or having a STI.ConclusionFSI is associated with infrequent condom use, recent experiences of violence and mental health outcomes among youth in sub-Saharan Africa, which may increase the risk for HIV and other consequences. Developing strategies for prevention is important for reducing the prevalence of FSI and its effects on children and youth.  相似文献   

6.
Fifteen‐year‐old adolescents (N = 109) in a longitudinal study of child development were recruited to examine differences in DNA methylation in relation to parent reports of adversity during the adolescents’ infancy and preschool periods. Microarray technology applied to 28,000 cytosine–guanine dinucleotide sites within DNA derived from buccal epithelial cells showed differential methylation among adolescents whose parents reported high levels of stress during their children’s early lives. Maternal stressors in infancy and paternal stressors in the preschool years were most strongly predictive of differential methylation, and the patterning of such epigenetic marks varied by children’s gender. To the authors’ knowledge, this is the first report of prospective associations between adversities in early childhood and the epigenetic conformation of adolescents’ genomic DNA.  相似文献   

7.
Bullying at school has far-reaching impacts on adolescent well-being and health. The aim of this study was to examine trends in bullying at school according to socioeconomic adversities among Finnish adolescents from 2000 to 2015. A population-based school survey was conducted biennially among 14–16-year-old Finns between 2000 and 2015 (n = 761,278). Distributions for bullying, being bullied and socioeconomic adversities were calculated. Associations between bullying involvement, time and socioeconomic adversities were studied using binomial logistic regression with results shown by odds ratios with 95% confidence intervals. At the population level, the likelihoods of bullying and being bullied varied only slightly between 2000 and 2015. Bullying and being bullied were associated with socioeconomic adversities (low parental education, not living with both parents and parental unemployment in the past year). Unlike in the general population, the likelihoods of bullying and being bullied increased markedly among adolescents with most socioeconomic adversities. The increased socioeconomic differences in bullying involvement observed in this study add to the mounting evidence of polarization of adolescent health and well-being. Socioeconomic adversities should be considered in the prevention of bullying at school. In addition, socio-political measures are needed to decrease socioeconomic inequalities among Finnish adolescents.  相似文献   

8.
Abstract

Recent literature on bullying suggests that victims of KEYW ORDS bullying are likely to have certain emotional reactions that contribute anti-bullying to the problem. This is not to say that victims in any way deserve the intervention; treatment that they get from more aggressive peers, but rather to bullying; propose that they themselves can be empowered to change the situ-bystanders; ation. The purpose of the present review is to examine the proposal emotional that the ways in which victims express their emotions during a bullying expression episode can play a crucial role in the responses of peers. There are implications for both researchers and practitioners to develop new insights that may help vulnerable children and adolescents.  相似文献   

9.
BackgroundExtensive research has documented the association between adverse childhood experiences (ACEs) and poor outcomes later in life, as well as the high prevalence of ACEs in the American population. Studies consistently find that over half of American adults have experienced at least one ACE. Despite this, research on the long-term impacts of ACEs is challenging due to the complex nature of adversity.ObjectiveOur study aimed to define underlying constructs of adversity, and explore how they changed throughout childhood, in a low-income population.Participants and SettingWe fielded a survey to Medicaid-enrolled adults in the Portland, OR metropolitan area.MethodsOur survey captured different experiences in childhood, including relationships and support, educational challenges, housing and employment stability, neighborhood environment, discrimination, abuse, neglect, and household dysfunction; questions were asked for 6–12 and 13–18 years of age. We then used factor analysis to identify underlying constructs of adversity in the two age ranges.ResultsWe identified two factors - Inadequate Emotional Support and Instability – in each age range. Inadequate Emotional Support remained consistent in both time periods while the Instability factor changed, expanding from household-centric experiences in childhood to a wider variety of experiences in adolescence. Additionally, a number of variables did not load on either factor in either age range.ConclusionsThese results underscore the importance of expanding how we think about instability specifically, and childhood adversity in general.  相似文献   

10.
Childhood adversities are strong predictors of psychopathology and suicidality. However, specific adversities are associated with different outcomes, with cross-national variations reported. The current study examined rates of adversities reported in Northern Ireland (NI), and associations between adverse childhood experiences and psychopathology and suicidal behaviour were explored. Data was obtained from the Northern Ireland Study of Health and Stress (NISHS), conducted as part of the World Mental Health (WMH) survey initiative (2004–2008); response rate 68.4% (n = 1,986). The on-line survey used, the WHO Composite International Diagnostic Interview (CIDI) to examine psychopathology and associated risk factors in the NI population. Prevalence rates of retrospectively reported childhood adversities were calculated, with gender and age variations explored. Females were more likely to experience sexual abuse. Individuals who grew up during the worst years of the civil conflict in NI experienced elevated levels of childhood adversities. Participants who endured childhood adversities were more likely to have mental health problems but variations in risk factors were found for different disorders. Parental mental illness was associated with all disorders however, with ORs ranging from 2.20 for mood disorders to 4.07 for anxiety disorders. Population attributable fractions (PAF) estimated the reduction in psychopathology and suicidal behaviour in the population if exposure to adverse childhood events had not occurred. The highest PAF values were revealed for parental mental illness and sexual abuse. The findings indicate that a substantial proportion of psychopathology and suicide risk in NI are attributable to childhood adversities, providing support for early intervention and prevention initiatives.  相似文献   

11.
BackgroundThere is limited data available regarding the most common forms of psychiatric illness, the occurrence of childhood adversity, and the link between childhood adversity and criminal and psychiatric outcomes amongst forensic inpatients.AimsUsing census data for all Scottish forensic inpatients, we investigated the most common primary psychiatric diagnoses in forensic settings, the occurrence of childhood adversity amongst forensic inpatients, and whether childhood adversity experiences significantly predict a range of criminal and psychiatric outcomes.MethodData for the current study were drawn from ‘The Scottish Forensic Network Inpatient Census’ (N = 422). The Responsible Medical Officers and other members of the clinical team collected all data from official patient records. All forensic inpatients across high, medium, and low security sites were surveyed.ResultsThe majority of patients had a psychotic disorder as their primary diagnosis (86.4%), with schizophrenia being the most common (70.0%). Childhood adversity was highly prevalent (79.2%), with physical abuse being the most common adverse experience (40.1%). Increased levels of childhood adversity were significantly associated with an increased risk of criminal convictions, self-reported abuse of animals, suicidal and self-injurious behaviour, and problematic use of drugs or alcohol.ConclusionsConsidering the association between adversity and psychosis, trauma informed care is essential for the mental health and forensic needs of this population.  相似文献   

12.

Objectives

There is much evidence showing that childhood adversities have considerable effects on the mental and physical health of adults. It could be assumed therefore, that the disease burden of childhood adversities is high. It has not yet been examined, however, whether this is true.

Method

We used data of a large representative sample (N = 7,076) of the general population in the Netherlands. We calculated the disability weight (DW) for each respondent. The DW is a weight factor that reflects the severity of a disease or condition on a scale from 0 (perfect health) to 1 (equivalent to death). We used an algorithm based on the SF-6D to estimate DW. Because the DW indicates the proportion of a healthy life year that is reduced by the specific health state of the individual, it also possible to calculate the total number of years lost due to disability (YLD) in the population. We calculated the years lived with disability (YLD) for 9 different childhood adversities (in the areas of parental psychopathology; abuse and neglect; major life events), as well as for major categories of mental disorders and general medical disorders.

Results

All 9 adversities resulted in a significantly increased DW, except death of a parent before the age of 16. Adversities in the category of abuse and neglect are associated with the highest DWs (0.057), followed by parental psychopathology (0.031) and life events during childhood (0.012). All adversities (46.4% of the population reports one or more adversity) are associated with 20.7 YLD/1,000, which is more than all mental disorders together (12.9 YLD/1,000). The category of abuse/neglect has the highest YLD/1,000 (15.8), which is also higher than all mental disorders together. Adjustment for the presence of mental and general medical disorders resulted in comparable outcomes.

Conclusions

Childhood adversities are more important from a public health point of view than all common mental disorders together, and should be a priority for public health interventions.  相似文献   

13.
This study created a Spanish triangulated version of the European Bullying Intervention Project Questionnaire and obtained indicators of its validity and reliability. This new tool allows researchers to triangulate and flexibly investigate the three main roles in school bullying, obtaining seven potential roles (pure victim, pure bully, pure bystander, bully/victim, victim/bystander, bully/bystander, and bully/victim/bystander). The sample was 2,068 adolescents and young adults aged 11–19 years (Mage = 14.2 ± 1.48 years old; 53.8% females). Confirmatory factor analysis indicated a good fit for the three-related-factor model and adequate reliability (ω > 0.91) in all dimensions. About 28.2% of the sample reported victimization; of whom only 2.9% were pure victims, 15.1% were victim/bystanders, and 9.8% were involved in all three roles (bully/victim/bystanders). Only 0.8% played the role of a pure bully, and 0.4% were bully/victims. The most prevalent profile was that of pure bystander (30%). These results are discussed in light of their importance for the interpretation of the prevalence of traditional bullying, and their implications for bullying assessments and interventions.  相似文献   

14.
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15.
For educators to help children exposed to adverse life experiences, it is necessary to understand how adversity impacts different mechanisms of learning, emotion, and planning as these capacities underpin success in schools and beyond. The goal of this paper is to review essential findings on how early life adversity transforms the brain which, in turn, impacts educational outcomes. Part 1 begins by discussing the species‐specific and expectant experiences that guide typical development, and then turns to early life adversities and their relationship to both physical and mental health outcomes. Part 2 summarizes four dimensions of adversity—type, timing, term, and toxicity—and how each differentially impacts the developing brain, including individual differences in psychopathology. Part 3 discusses the relevance of these findings for educators, highlighting how behavior can be modified to build resilience and greater academic and social–emotional competency.  相似文献   

16.
BackgroundAdverse childhood experiences (ACEs) can have lifelong adverse impacts on health and behavior. While this relationship has been extensively documented in high-income countries, evidence from lower-income contexts is largely missing. In order to stimulate greater research on the prevalence and consequences of ACEs in low-income countries, the World Health Organization (WHO) developed the ACE-International Questionnaire (ACE-IQ).ObjectiveIn this paper, we explore the factor structure, validity and reliability of the original ACE-IQ, and evaluate whether potential adaptations improve its predictive validity.Participants and settingFour hundred and ten adolescents (age 10–16 years old) from Malawi.MethodsThe adolescents answered an adapted version of ACE-IQ and Beck Depression Inventory (BDI).ResultsTaken together, our results suggest that (a) the ACE-IQ is structured in three dimensions: household disruption, abuse, and neglect; (b) there is support for the validity of the scale evidenced by the correlation between subdimensions (average across 13 correlations, phi = .20, p < 0,01; across subdomains (phi = .10, p < 0,01); partial agreement among children with the same caregiver (ICC = .43, p < .001) and correlation between ACE and depression (predictive validity; r = .35, p < .001); (c) information on the timing of the adversities (“last year” in addition to “ever”) modestly improved the predictive value of the ACE-IQ in models of depression (from R2 = .12 to .15, p < .001); and (d) additional HIV-related questions showed low endorsement and a modest correlation with BDI (r = .25, p < 0,01).ConclusionOur findings suggest that the ACE-IQ is appropriate for use among adolescents from a low-income context.  相似文献   

17.
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18.
BackgroundIntegrative research summarizing promotive and protective factors that reduce the effects of childhood abuse and neglect on pregnant women and their babies’ healthy functioning is needed.ObjectiveThis narrative systematic review synthesized the quantitative literature on protective and promotive factors that support maternal mental health and maternal-infant bonding among women exposed to childhood adversity, including childhood abuse and neglect.MethodsUsing a comprehensive list of key terms related to the perinatal period, childhood adversity, and protective/promotive factors, 8423 non-duplicated articles were identified through database searches in PsychInfo and Web of Science, and references in retrieved articles. Thirty-seven full text articles were inspected; of those 18 were included.ResultsProtective and promotive factors fell into three categories: a) women’s internal capacities (e.g., self-esteem, coping ability), b) external early resources (e.g., positive childhood experiences) and c) external contemporaneous resources (e.g., social support). Although all three categories were associated with more resilient outcomes, external contemporaneous factors, and specifically, social support, were the most commonly-studied protective and/or promotive factor. Social support from family and romantic partners during the perinatal period was particularly protective for women with histories of childhood abuse and neglect and was examined across several dimensions of support and contexts.ConclusionsThe presence of women’s internal capacities, and external early and contemporaneous resources help to foster more positive outcomes during the perinatal period for women with histories of childhood adversity. Future research should study co-occurring multilevel promotive and protective factors to inform how they integratively deter the intergenerational transmission of risk.  相似文献   

19.
Children investigated for maltreatment are particularly vulnerable to experiencing multiple adversities. Few studies have examined the extent to which experiences of adversity and different types of maltreatment co-occur in this most vulnerable population of children. Understanding the complex nature of childhood adversity may inform the enhanced tailoring of practices to better meet the needs of maltreated children. Using cross-sectional data from the National Survey of Child and Adolescent Well-Being II (N = 5870), this study employed latent class analysis to identify subgroups of children who had experienced multiple forms of maltreatment and associated adversities among four developmental stages: birth to 23 months (infants), 2–5 (preschool age), 6–10 (school age), and 11–18 years-old (adolescents). Three latent classes were identified for infants, preschool-aged children, and adolescents, and four latent classes were identified for school-aged children. Among infants, the groups were characterized by experiences of (1) physical neglect/emotional abuse/caregiver treated violently, (2) physical neglect/household dysfunction, and (3) caregiver divorce. For preschool-aged children, the groups included (1) physical neglect/emotional abuse/caregiver treated violently, (2) physical neglect/household dysfunction, and (3) emotional abuse. Children in the school-age group clustered based on experiencing (1) physical neglect/emotional neglect and abuse/caregiver treated violently, (2) physical neglect/household dysfunction, (3) emotional abuse, and (4) emotional abuse/caregiver divorce. Finally, adolescents were grouped based on (1) physical neglect/emotional abuse/household dysfunction, (2) physical abuse/emotional abuse/household dysfunction, and (3) emotional abuse/caregiver divorce. The results indicate distinct classes of adversity experienced among children investigated for child maltreatment, with both stability across developmental periods and unique age-related vulnerabilities. Implications for practice and future research are discussed.  相似文献   

20.
ObjectiveMajor depression is often accompanied by deficits in cognitive functioning and lowered executive functions. However, not all depressed patients show impairments in these domains. The aim of this study was to examine whether different kinds of childhood adversity might account for cognitive deficits in patients with major depression.MethodsNinety-one patients with major depression (DSM-IV) and 40 healthy controls completed a neuropsychological test battery assessing memory, processing speed and executive functions. The Childhood Trauma Questionnaire (CTQ) was used to measure the severity and number of incidences of sexual, physical and emotional abuse and physical and emotional neglect.ResultsPatients with major depression had a significantly higher number of traumas and reported more severe emotional abuse, emotional neglect and physical neglect than healthy controls. Patients performed less well in memory tasks, general knowledge and processing speed than healthy controls. Hierarchical regression analyses indicated that the overall number of traumas was significantly associated with poorer general knowledge, lower processing speed and impaired executive functions in patients with major depression. A second model including all CTQ-subscales simultaneously demonstrated an association between physical neglect and poorer verbal learning, and physical abuse and diminished executive functions.ConclusionA higher number of childhood adversities may influence general knowledge, processing speed and executive functions in patients with major depression. In addition, physical abuse and neglect seemed to be associated with verbal learning deficits and poorer executive functions.  相似文献   

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