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1.
BackgroundCollege students with suicidal ideation (SI) are at high risk of suicide. Adverse childhood experiences (ACEs) are important risk factors for suicidal behavior. Most research in this area has been restricted to 10 conventional ACEs and suggests negative long-term developmental effects from other common childhood adversities such as peer victimization, peer isolation/rejection, exposure to community violence, and low socioeconomic status.ObjectiveTo test the unique and cumulative associations of 14 different ACEs with SI among young adults.Participants and SettingParticipants were 989 college students from two universities in China’s provincial-leveled Hui Autonomous Region.MethodsAssociations between ACEs and SI were analyzed by logistic regression. A Chi-square trend test was used to examine the association between cumulative ACEs and SI.ResultsThe rates of suicidal ideation, plans, and attempts among the cohort were 11.9%, 3.7%, and 1.6%, respectively; 43.9% had experienced at least one ACE. The strongest predictor of SI in adulthood was peer isolation/rejection, followed by emotional neglect, then low socioeconomic status. There was a cumulative effect of ACEs and SI, whereby the greater the number of ACEs, the greater the likelihood of SI.ConclusionPeer isolation/rejection, emotional neglect, and low socioeconomic status were associated with increased risk of SI in adulthood. Two (peer isolation/rejection and low socioeconomic status) of the three factors that emerged from the analysis are not typically included in ACEs research. There was a cumulative effect of 14 kinds of ACEs on SI among young adults. Early recognition of risk factors is therefore important. 相似文献
2.
BackgroundNumerous studies over the past two decades have found a link between adverse childhood experiences (ACEs) and worse adult health outcomes. Less well understood is how advantageous childhood experiences (counter-ACEs) may lead to better adult health, especially in the presence of adversity.ObjectiveTo examine how counter-ACEs and ACEs affect adult physical and mental health using Resiliency Theory as the theoretical framework.Participants and settingParticipants were Amazon mTurk users ages 19–57 years (N = 246; 42% female) who completed an online survey.MethodsWe conducted a series of regression analyses to examine how counter-ACEs and ACEs predicted adult health.ResultsCorresponding to the Compensatory Model of Resiliency Theory, higher counter-ACEs scores were associated with improved adult health and that counter-ACEs neutralized the negative impact of ACEs on adult health. Contrary to the Protective Factors Model, there was a stronger relationship between ACEs and worse adult health among those with above average counter-ACEs scores compared to those with below average counter-ACEs scores. Consistent with the Challenge Model, counter-ACEs had a reduced positive effect on adult health among those with four or more ACEs compared to those with fewer than four ACEs.ConclusionsOverall, the findings suggest that counter-ACEs protect against poor adult health and lead to better adult wellness. When ACEs scores are moderate, counter-ACEs largely neutralize the negative effects of ACEs on adult health. Ultimately, the results demonstrate that a public health approach to promoting positive childhood experiences may promote better lifelong health. 相似文献
3.
BackgroundDespite strong associations between adverse childhood experiences (ACEs) and poor health, few studies have examined the cumulative impact of ACEs on causes of childhood mortality.MethodsThis study explored if data routinely collected by child death overview panels (CDOPs) could be used to measure ACE exposure and examined associations between ACEs and child death categories. Data covering four years (2012–2016) of cases from a CDOP in North West England were examined.ResultsOf 489 cases, 20% were identified as having ≥4 ACEs. Deaths of children with ≥4 ACEs were 22.26 (5.72–86.59) times more likely (than those with 0 ACEs) to be classified as ‘avoidable and non-natural’ causes (e.g., injury, abuse, suicide; compared with ‘genetic and medical conditions’). Such children were also 3.44 (1.75–6.73) times more likely to have their deaths classified as ‘chronic and acute conditions’.ConclusionsThis study evidences that a history of ACEs can be compiled from CDOP records. Measurements of ACE prevalence in retrospective studies will miss individuals who died in childhood and may underestimate the impacts of ACEs on lifetime health. Strong associations between ACEs and deaths from ‘chronic and acute conditions’ suggest that ACEs may be important factors in child deaths in addition to those classified as ‘avoidable and non-natural’. Results add to an already compelling case for ACE prevention in the general population and families affected by child health problems. Broader use of routinely collected child death records could play an important role in improving multi-agency awareness of ACEs and their negative health and mortality risks as well in the development of ACE informed responses. 相似文献
4.
BackgroundAdverse childhood experiences (ACEs) are an identified risk factor for the social and emotional development of children. What is less known is the long-term effects of ACEs when poverty and ACEs coincide.ObjectiveUsing longitudinal cohort-panel data, we examined whether exposure to ACEs by the age of three among poor children would longitudinally result in behavioral problems at ages three, five, nine, and 15, after controlling for mothers’ socioeconomic status and their children’s characteristics.Participants and settingWe used a subsample of 2750 children and their parents living in urban poverty from the Fragile Families and Child Wellbeing study.MethodsLogistic regression modeling was used to obtain adjusted odds ratios of ACE categories predicting behavioral problems after accounting for family socioeconomic position.ResultsOur findings indicate that experiencing ACEs in early childhood was significantly associated with later behavioral outcomes from childhood to adolescence. Exposure to multiple ACEs before the age of three was significantly associated with the top-risk behavior group at age five; the odd ratios were 2.0 (CI = 1.3–3.1) and 2.9 (CI = 1.8–4.6) for two ACEs and three or more ACEs, respectively. At both ages nine and 15, children experiencing two or more ACEs had 1.9 to 3.2 times higher odds to demonstrate more the top 10th percentile of behavioral problems. Among covariates, mothers’ race and education, and children’s gender and temperament were identified as significant factors to determine behavior problems.ConclusionsThe findings support policies and programs for families with children who have experienced economic disadvantages and early childhood adversity. 相似文献
5.
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
6.
BackgroundAdverse childhood experiences (ACEs) have been linked with an increased tendency to experience self-conscious emotions (i.e., shame- and guilt-proneness). Further, interpersonal problems have been associated with ACEs and are implicated in the maintenance of shameand guilt-proneness.ObjectiveThe aim of the present study was to better understand the interpersonal pathways through which ACEs are associated with shame- and guilt-proneness.MethodA community sample (N = 249) completed measures of ACEs, interpersonal problems, and shame- and guilt-proneness.ResultsInterpersonal problems mediated the association between ACEs and shame-proneness and ACEs and guilt-proneness. Multiple mediation models revealed that—when controlling for the other types of interpersonal problems—(a) interpersonal sensitivity was the only significant mediator between ACEs and shame-proneness and (b) interpersonal sensitivity and interpersonal aggression mediated the association between ACEs and guiltproneness.ConclusionsThese findings highlight the importance of interpersonal pathways in the association between shame- and guilt-proneness. Theoretical and practical implications are discussed. 相似文献
7.
BackgroundPrior research suggests that those experiencing adverse childhood experiences (ACEs) may be higher utilizers of the healthcare system. The frequency and financial impact of kept, cancelled and no-showed visits is largely unknown.ObjectiveTo examine the impact of adverse childhood experiences (ACEs) on healthcare utilization in a sample of US adults.Participants and SettingTwo thousand thirty-eight adult patients who completed an ACE screening within the behavioral health department of a medium sized, Midwestern healthcare system during 2015–2017 were included.MethodsData was extracted retrospectively from 1-year post ACE screen.ResultsIndividuals with high ACEs (4+) made more but kept fewer appointments than those with no or moderate (1–3) ACEs (p < 0.0001). Individuals with high ACES had more late-cancelled and no-showed appointments compared to those with no ACEs (p’s < .0001). Relationships were significant even after controlling for age, gender, and insurance type. Those with high ACEs had the greatest impact on potential lost revenue given that they late-cancelled and no-showed more appointments. Those with high ACEs also had more medical comorbidities, medications, and needed care coordinator than those with moderate or no ACEs (p’s < .05)ConclusionsResults from this study should be used to inform providers and health care systems on the effects of adversity on patterns of utilization of health care and encourage innovative strategies to better address the needs of these patients. 相似文献
8.
BackgroundInvestigations have found mothers’ adverse childhood experiences (ACEs) confer an intergenerational risk to their children's outcomes. However, mechanisms underlying this transmission have only been partially explained by maternal mental health. Adult attachment insecurity has been shown to mediate the association of ACEs and mental health outcomes, yet an extension of this research to children's behavioral problems has not been examined.ObjectiveTo examine the cascade from maternal ACEs to risk for child behavioral problems at five years of age, via mothers’ attachment insecurity and mental health.Participants and settingParticipants in the current study were 1994 mother-child dyads from a prospective longitudinal cohort collected from January 2011 to October 2014.MethodsMothers retrospectively reported their ACEs when children were 36 months of age. When children were 60 months of age, mothers completed measures of their attachment style, depression and anxiety symptoms, and their children's behavior problems.ResultsPath analysis demonstrated maternal ACEs were associated with children's internalizing problems indirectly via maternal attachment avoidance, attachment anxiety, and depression symptoms, but not directly (β = .05, 95% CI [−.001, .10]). Maternal ACEs indirectly predicted children's externalizing problems via maternal attachment avoidance, attachment anxiety, and depression. A direct effect was also observed from maternal ACEs to child externalizing problems (β = .06, 95% CI [.01, .11]).ConclusionsMaternal ACEs influenced children's risk for poor behavioral outcomes via direct and indirect intermediary pathways. Addressing maternal insecure attachment style and depression symptoms as intervention targets for mothers with histories of ACEs may help to mitigate the intergenerational transmission of risk. 相似文献
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10.
The aims of this study were to identify latent classes of adverse childhood experiences (ACEs) in a large sample of college students (N = 8997), investigate the relations between ACEs classes and life functioning, and compare results using latent class analysis to analyses using cumulative risk scores. Nine types of ACEs were assessed (three types of child abuse and six types of household dysfunction). Outcomes were self-report measures of mental health, physical health, alcohol consequences, and academic performance. Latent class analysis (LCA) results indicated that four classes fit the data best across random halves of the sample and were labeled High ACEs, Moderate Risk of Non-Violent Household Dysfunction, Emotional and Physical Child Abuse, and Low ACEs. Comparing across latent classes, the largest differences in outcomes were between the High ACEs and Low ACEs classes. There were no differences in outcomes between the Moderate Risk of Non-Violent Household Dysfunction and Emotional and Physical Child Abuse classes. The largest between-class differences were found for mental health and the smallest differences were found for academic performance. Comparing results using LCA latent classes and cumulative ACEs scores, the differences between the High and Low ACEs latent classes were similar to the differences between those with zero ACEs and those with 5 or more ACEs. Both approaches also accounted for roughly equivalent amounts of variance in all outcomes. Thus, latent class and cumulative risk analyses provided similar results with regard to predicting outcomes of interest among college students. 相似文献
11.
BackgroundAdverse childhood experiences (ACEs) are a potent risk factor. Despite these findings, studies have also recognized the importance of considering additional sources of genetic and environmental influence that cluster within families.ObjectiveTo properly control for latent sources of genetic and within-family environmental influences and isolate the association between ACEs and the following outcomes in adulthood: physical health, depressive symptoms, educational attainment, income attainment, alcohol problems, and antisocial behavior.Participants and SettingTwo independent samples of twins and siblings from the United States: the Midlife Development in the United States (MIDUS) study (N = 862) and the National Longitudinal Study of Adolescent to Adult Health (Add Health; N = 3112).MethodsSibling comparison models, which control for latent sources of genetic and within-family environmental influences, were estimated to examine whether differential exposure to ACEs was associated with the examined outcomes.ResultsFamilies that experienced more adversity also experienced more deleterious outcomes. However, siblings that experienced more adversity were no more likely to experience deleterious outcomes than their co-siblings. However, greater exposure to ACEs was associated with increases in depressive symptoms (Add Health). Additional models revealed that the similarity between siblings from the same family stemmed from latent sources of within-family environmental influences not captured by traditional ACEs measures.ConclusionsConsidering genetic influences and additional latent sources of within-family influences is crucial in isolating the effects of ACEs. Currently employed ACEs measures may not adequately capture the full range of impactful sources of family-level environmental influence. 相似文献
12.
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
13.
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
14.
ObjectiveThe purpose of this study was to estimate the prevalence of adverse childhood experiences (ACEs) among children in the United States and to examine the relationship between child and family characteristics and the likelihood of reported exposure to ACEs.MethodsData were drawn from the nationally representative 2016 National Survey of Children’s Health (NSCH). Parent-reported child ACE exposure was measured using counts of those reporting zero ACEs, one to three ACEs, and four or more ACEs.ResultsThe study sample included 45,287 children. The most prevalent types of ACE exposure experienced by children were economic hardship (22.5%) and parent or guardian divorce or separation (21.9%). Older children (34.7%), Non-Hispanic African American children (34.7%), children with special health care needs (SHCN; 36.3%), children living in poverty (37.2%), and children living in rural areas (30.5%) were more likely to be exposed to parental divorce or separation than their counterparts. Five cross-cutting factors emerged as important across outcomes: child’s age, family structure, poverty, type of health insurance, and SHCN status.ConclusionsWe found high prevalence rates of economic hardship on a national level. Our findings of higher prevalence among rural children further suggest the importance of the intersection of place and ACEs. Therefore, the geographic component of ACEs must be considered by policymakers. The identification of predictive factors related to high ACE exposure can inform early interventions at the national level. 相似文献
15.
BackgroundAdverse childhood experience (ACE) and intimate partner violence (IPV) have sustained, deleterious effects on physical and mental health. Few studies have examined how to help Latina survivors of ACEs and/or IPV regain control of their health.ObjectiveTo inform interventions for this population, we examined whether mastery of stress and patient activation mediate the relationship between a history of ACE and/or IPV and mental and physical health.Participants and settingWe recruited 235 Latina women (M age = 29.6, SD = 5.75) from primary care clinics.MethodFor this cross-sectional study, we used linear regressions to examine the association between ACEs, history of IPV, and health, and the sobel’s test to determine whether patient activation and mastery of stress mediated the relationships between ACEs, IPV, and health.ResultsMost women reported at least one ACE (61.7%, n = 137) and 22.2% (n = 55) reported a history of IPV. Mastery of stress mediated the relationship between ACE and physical health (b= -3.16 p = .002) and mental health (b= -3.83, p < .001). Mastery of stress also mediated the relationship between history of IPV and physical health (b= -2.62, p = .008) and mental health (b= -2.74, p = .006). Patient activation was not associated with a history of trauma or mental health.ConclusionWhile past experiences of trauma cannot be changed, results from this study suggest that improving an individual’s mastery of stress may be a point of intervention for improving mental and physical health among survivors of ACEs and IPV. 相似文献
16.
Patrick Tompkins Mitchell R. Williams Shana Pribesh 《Community College Journal of Research & Practice》2013,37(5):370-381
ABSTRACTLate registration is a common practice in community colleges, but the evidence-based argument for the presumed deleterious effects of late registration on student success is weaker than is commonly believed, and there has been no published research on how success rates may differ for late registrants in online and on-campus classes, and for students who complete a college success skills course. Using nearly 100,000 matched enrollment cases from Virginia’s Community Colleges, we predict the effect of late registration on student success for first-time-in-college students. The statistically significant results indicate late registration is negatively related to student success, especially for students with other success risk factors. Attending face-to-face classes as well as completing a college skills course were independently and positively related to course success. Interestingly, late registration interacted with both course delivery mode and college skills course completion indicating that late registration does not impact students equally. 相似文献
17.
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
18.
BackgroundAdverse Childhood Experiences (ACEs) may have a life-long impact on mental health and are related to physical disease, such as diabetes and cardiovascular diseases in adulthood. Research on ACEs suffers from recall bias when performed with adults.ObjectiveTo estimate the prevalence of ACEs and the interrelationships between ACEs as reported by children, and to determine the impact on their self-reported quality of life (QoL). Children’s opinions on the ACE-Questionnaire were also obtained.MethodA cross-sectional study was conducted with a child version of the ACE-Questionnaire. This questionnaire assesses parental separation or divorce, physical and emotional child abuse and neglect, sexual violence, domestic violence, household substance abuse, psychological issues or suicide, and incarceration of a household member. QoL was measured with the Kidscreen-10.Participants and settingThe questionnaire was completed by 644 children at a mean age of 11 years (range 9–13 years), in the two last grades of regular elementary schools, recruited throughout the Netherlands.ResultsData were weighted by ethnicity to obtain a representative sample of children in Dutch elementary education. Of all children, 45.3% had one or more out of ten ACEs. Child maltreatment was experienced by 26.4%. ACEs often co-occurred. A higher number of ACEs correlated with a lower mean level of QoL (p < 0.001). Mean QoL was 8.5 points lower (Cohen’s d = 0.8) in children who experienced child maltreatment. Children’s opinions on the questionnaire were positive in 82.4%.ConclusionPrevention of ACEs, professional training and trauma-focus in schools are urgently needed. 相似文献
19.
The goal was to identify factors that might affect likelihood of seeking health-related interventions for young adults with adverse childhood experiences (ACEs). We tested whether ACEs were associated with (1) regulatory focus (tendency toward promoting good outcomes versus preventing bad outcomes), and (2) patient activation (the intention to take active charge of one’s health). We further tested whether promotion and prevention and patient activation were associated with each other and with health. Students at a public university (N = 321) completed online questionnaires assessing ACEs, regulatory focus, patient activation, and health. Greater childhood adversity showed small but significant associations with being a less activated patient and being less focused on promoting good outcomes. In contrast, greater childhood adversity had a much stronger association with focusing on preventing negative outcomes. Students with a more significant mental health history were more likely to have been exposed to childhood adversity, to be less activated patients, and to focus more on prevention. Results suggest that using a prevention focus may be effective in health messages aimed to reach individuals with high levels of ACEs. Furthermore, individuals with high levels of ACEs may benefit from interventions aimed at increasing patient activation. 相似文献
20.
Adverse childhood experiences (ACEs) are risk factors for interpersonal difficulties in adulthood, however the mechanism that underlies this association is unknown. The current study investigated the association of a wide range of ACEs with interpersonal difficulties in adulthood, and tested whether emotion dysregulation mediated the relationship between ACEs and interpersonal difficulties. Patients over the age of 18 were recruited from primary care clinics (N = 4006). Participants completed self-report questionnaires that assessed ACEs, emotion dysregulation, and interpersonal difficulties. Results indicated that, after controlling for a range of demographic variables, each type of ACE significantly predicted increased interpersonal difficulties and that cumulative ACEs predicted increased interpersonal difficulties, F(8, 3137) = 39.68, p < .001, R2 = 0.09. Further, emotion dysregulation mediated the association between ACEs and interpersonal difficulties, B = 0.79, SE = 0.09, 95% CI [0.64, 0.97]. These findings emphasize the role of childhood adversity on interpersonal functioning in adulthood, and highlight emotion dysregulation as a mechanism by which this association occurs. Results have the potential to inform preventative and treatment efforts to improve adaptive outcomes among individuals with a history of childhood adversity. 相似文献