Latest Peer Reviewed Papers
The three most common types of ACE were physical neglect (69.8%), emotional neglect (28.2%), and emotional abuse (22.9%). For specific ACE, emotional abuse was significantly associated with Personality Disorder traits, whereas emotional and physical neglect types of ACE was significantly associated with negative symptoms. A higher level of physical abuse was more commonly reported by men, younger individuals, and those with a higher level of antisocial PD traits. Higher levels of physical neglect were associated with more severe negative symptoms. ACE’s are commonly observed in patients with schizophrenia. Therefore, it is strongly recommended that this clinical population be provided with a comprehensive assessment and individualized intervention for those exposed to specific ACE’s.
Older adults with ACEs had longer proportion of remaining life with depression compared with those without ACEs. For example, men aged 60 years with ACEs could expect to live 5.2 years with depression compared with 2.8 years for men without ACEs. Women aged 60 years who reported ACEs could expect to live 9.4 years with depression compared with 6.0 years for women without ACEs. With a high level of educational attainment, older adults from younger cohorts with ACEs lived fewer depression years and spent a higher proportion of their life being free of depression than adults with ACEs and had a low level of educational attainment. Our results indicated that ACEs may increase years of life with depression among U.K. adults. Meanwhile, high educational attainment could mitigate the mental health burden associated with ACEs.
The adverse childhood experiences questionnaire: Two decades of research on childhood trauma as a primary cause of adult mental illness, addiction, and medical diseases
Adverse childhood experiences and rearing may generate a public health burden that could rival or exceed all other root causes. Translating this information to health-care reform will require strengthening brain-behavioral health as core public and preventative health-care missions. Greater integration of mental health and addiction services for parents should be accompanied by more research into brain mechanisms impacted by different forms and interactions between adverse childhood experiences
To examine the relationship between adverse childhood experiences (ACEs) and Attention-deficit Hyperactivity Disorder (ADHD) among college students. We investigated the association between ACEs and ADHD symptoms among French college students.The sample comprised 1062 participants with a mean age of 20.3 of which 30.6% had no ACEs exposure, 29.6% had 1 ACE, 19.2% had 2 ACEs, and 20.6% had ≥ 3 ACEs. After controlling for potential confounders, every increase in ACE exposure heightened the risk of ADHD symptoms. 1 ACE: 2.1 2 ACEs: 4.5 ≥ 3 ACEs: 5.2 . Estimates for ADHD symptoms were higher with sexual abuse, emotional and physical neglect, and bullying. Findings suggest that ACEs heighten the risk for developing ADHD symptoms among college students and bear important implications for prevention and clinical practice.
How do we organize our thinking with regard to our young people and what can we do to Help them?
‘The way we define their problems, our diagnosis, will determine how we approach their care. Such patients typically receive five or six different unrelated diagnoses in the course of their psychiatric treatment. If their doctors focus on their mood swings, they will be identified as bipolar and prescribed lithium or valproate. If the professionals are most impressed with their despair, they will be told they are suffering from major depression and given antidepressants. If the doctors focus on their restlessness and lack of attention, they may be categorized as ADHD and treated with Ritalin or other stimulants. And if the clinic staff happens to take a trauma history, and the patient actually volunteers the relevant information, he or she might receive the diagnosis of PTSD. None of these diagnoses will be completely off the mark, and none of them will begin to meaningfully describe who these patients are and what they suffer from.’
Kolk, Bessel van der. The Body Keeps the Score (pp. 136-137).
In previous years, adverse childhood experiences (ACEs) have been identified as having a potential relationship with poor health outcomes. Chronic pain is one health outcome that has a high prevalence worldwide and the numbers are continuing to grow. The findings of this scoping review suggest there is a potential relationship between ACEs and adulthood chronic pain. Allostatic load, which dysregulates the central nervous system or the hypothalamus pituitary adrenal (HPA) axis which puts people at a higher risk of chronic pain due to increased sensitivity to pain (Kendall-Tackett, Marshall, & Ness, 2003). Further, a dysregulated HPA axis was often attributed to mediating factors, including psychological disorders, such as depression (Danese & McEwen, 2012; Gonzalez et al., 2012; Borsini et al., 2014).
Another factor which contributes to the non-linear nature of the relationship between ACEs and chronic pain is related to the timing of physical and sexual abuse, which indicates that ACEs in the first five-years of life would put the child at increased risk of a dysregulated HPA axis (Lobo et al., 2022) and in turn increases the risk of experiencing chronic pain in adulthood. This could be due to the more vulnerable state that an infant is in, compared to a child that feels safe enough to go to school on their own (six years and older; Arnett et al., 2020) Coppens et al. (2017) have suggested that the impact of the ACEs rather than the mere presence of an ACE was a key factor in the relationship between ACE and chronic pain, which highlights the need to understand the impact of cumulation versus severity. To clarify, is one singular event of physical abuse enough to cause dysregulation in the HPA axis or a change in cortisol levels? Or does the ACE need to occur frequently? Allostatic load is based on the chronic activation of nervous, endocrine, and immune systems (Danese & McEwen, 2012). Therefore, it would be assumed that there needs to be a significant impact from the ACE, whether that means it occurred frequently to not allow the systems to return to normal functioning; or the ACE was severe enough for the systems to stay activated (e.g., sexual abuse). Within this hypothesis, it would also be assumed that the child’s level of resilience would determine how much the ACE impacted them.
Adverse childhood experiences, stress, and resilience among early childhood teachersResults indicated that a higher number of CEswas associated with a range of negative teacher functioning, above and beyond other workplace stressors. In some ways this is unsurprising, given the history of research documenting the association between ACEs and adjustment problems (Hughes et al., 2017; McElroy & Hevey, 2014); however, the prevalence of ACEs among teachers suggests it may be particularly important to examine the effects of these childhood experiences amongst a population responsible for the well-being of young children. It may be that programs addressing ACEs among caregivers can be adapted to meet the needs of teachers in caregiving-roles. Professional development trainings may need to consider including trauma-focused interventions for teachers in addition to general strategies for managing workplace stress. Further, institutions that provide certifications for early childhood teachers should consider incorporating ACEs and trauma-focused interventions into their curriculum to better equip new teachers entering the workforce. Although early childhood teachers are often taught to recognize and address ACEs among their students (Sciaraffa et al., 2018), present results suggest this training should be extended to identifying teacher’s own history of ACEs and need for building resilience.
Whole-school trauma-informed training does not seek to create ‘trauma specialists’ out of education staff but aims to ‘create a shared understanding of the impact of trauma exposure, build consensus for trauma-informed approaches and engender attitudes, beliefs and behaviours conducive to the adoption of system-wide trauma-informed approaches’ (Overstreet & Chafouleas, 2016, p. 2). The aim is for all adults to understand that any child may have experienced trauma, and to ensure that every adult has the capacity to provide trauma-informed emotional support if and when needed (Substance Abuse and Mental Health Services Administration, National Center for Trauma-Informed Care, 2014).
A polyvagal perspective clarifies the neurobiological and biobehavioral shifts that occurred during evolutionary transition from asocial reptiles to social mammals. This transition enabled mammals, unlike their reptilian ancestors, to derive a biological benefit from social interactions. This innovation enabled social behavior to function as a neuromodulator that could efficiently regulate and optimize autonomic function to support homeostatic processes. This journey is highlighted by the phylogenetic transition during which the autonomic nervous system was repurposed to suppress defensive strategies to support and express sociality. The product of this transition was an autonomic nervous system with capacities to self-calm, to spontaneous socially engage others, and to mitigate threat reactions in ourselves and others through social cues. Thus, social behavior became embedded with specific neurobiological processes that had capabilities to support homeostatic functions leading to optimized health, growth, and restoration. Polyvagal Theory emphasizes sociality as the core process in mitigating threat reactions and supporting mental and physical health.
One in four children around the world live in a conflict or disaster zone and crises can last for decades. Globally, refugee situations have become protracted with more children born to refugee parents spending their childhood, and at times their entire lives outside their country of origin. The challenges refugees face before, during, and after being displaced have serious consequences for families. Displacement often occurs multiple times and includes tremendous daily uncertainty. If families resettle, the process of adapting to new cultures requires and fosters remarkable resilience and navigational skills. This chapter tells the stories of how parents navigate challenging circumstances in three contexts: refugees within their own country, refugee camps outside of their country, and refugees who have resettled in a host country.
Prevalence and predictors of symptoms of Perinatal Mood and anxiety Disorders among a sample of Urban Black Women in the South
Perinatal mood and anxiety disorders (PMADs) are the most common complication of pregnancy. An estimated 15–21% of pregnant and postpartum women experience PMADs, with 1 in 7 affected by perinatal depression and 13–21% affected by perinatal anxiety. Among women who reported postpartum mental health concerns, Black women were less likely to receive follow-up treatment than white women. The absence of follow-ups may result in underdiagnosis and lack of treatment. Consequently, when postpartum depression goes untreated, it can severely affect the health and wellbeing of the woman and her family. The prevalence of PMAD symptoms among this sample of Black women was alarmingly high. Women who experienced PMADs were more likely to report adverse childhood experiences (e.g., physical, emotional, and/or sexual abuse). By understanding the prevalence of PMADs and the factors associated with these disorders, healthcare professionals can improve diagnosis and treatment rates among this understudied and underserved population.
144 Prevalence of adverse childhood experiences in a national sample of U.S. law enforcement officers
Law Enforcement Officers experience high rates of ACEs compared to the general population. In particular, officers in this sample reported exceptionally high levels of emotional abuse. Further research should explore how ACES differentially impact positive (like, resiliency) and negative (like, use of force) outcomes among professionals who are repeatedly exposed to high stress and traumatic events.
Sibling relationships are unique, and for some the most enduring we experience. These relationships can be categorised by love and warmth, however, can also be a point of escalating conflict and problems. Compared to other family relationships, sibling relationships are argued to be understudied despite being the longest-lasting relationship is most people’s lives. Siblings can provide an important source of support and play a vital role in an individual’s wellbeing , These relationships can be categorised by love and warmth, providing security and the opportunity to develop social abilities and self-identity. However, sibling relationships can also be a point of escalating conflict and problems. Some sibling relationships may be ingrained with rivalry and conflict, with distance being introduced when they leave the parental home. Several papers found evidence that older siblings often position themselves as carers, protecting their younger siblings from the ACE, who tend to be seen as more vulnerable. Depending on the type of adversity being experienced, the older siblings has been found to either buffer and reduce the potential impact for their younger siblings, or protect them from experiencing further abuse.
Role of thwarted belongingness, perceived burdensomeness and psychological distress in the association between adverse childhood experiences and suicidal ideation in college students.
Suicide has become one of the leading causes of death across all ages worldwide. Among those aged between 15 and 29 years, suicide is ranked second as a cause of death globally.1 Suicidal ideation, which is defined as thoughts to end one’s own life, is a pivotal precursor to later attempted and completed suicide, and is therefore considered to be a major public health matter.2 Among college students it is estimated that 15–30% have reported some degree of suicidal thoughts.
Creating a trauma-informed culture within the college community will foster an awareness of how past adverse experiences can affect students’ present functioning so that appropriate supports can be advertised and provided. Therefore, screening for ACEs, or at least considering their implications, has obvious use in clinical assessment and treatment,40 but also in interventions to reduce stress and improve the mental health of the college-going population.
Associations between adverse childhood experiences, attitudes towards COVID-19 restrictions and vaccine hesitancy: a cross-sectional study
Results Increasing ACE counts were independently related to low trust in NHS COVID-19 information, feeling unfairly restricted by government and ending mandatory face coverings. High ACE counts (4+ vs 0 ACEs) were also associated with supporting removal of social distancing. Breaking COVID-19 restrictions increased with ACE count with likelihood doubling from no ACEs to 4+ ACEs. Vaccine hesitancy was threefold higher with 4+ ACEs (vs n0 ACEs) and higher in younger age groups. Thus, modelled estimates of vaccine hesitancy ranged from 3.42% with no ACEs, aged ≥70 years, to 38.06% with 4+ ACEs, aged 18–29 years.
Conclusions ACEs are common across populations of many countries. Understanding how they impact trust in health advice and uptake of medical interventions could play a critical role in the continuing response to COVID-19 and controlling future pandemics. Individuals with ACEs suffer greater health risks throughout life and may also be excluded from interventions that reduce infection risks. While pandemic responses should consider how best to reach those suffering from ACEs, longer term, better compliance with public health advice is another reason to invest in safe and secure childhoods for all children.
Adverse childhood experiences, military adversities, and
adult health outcomes among female Veterans in the UK
A sizable percentage (55%) of participants reported experiencing one or more childhood adversities. The most frequently reported ACEs were emotional abuse, physical abuse, and
feeling unloved by family. Experiencing childhood adversities was most strongly associated with mental health difficulties such as posttraumatic stress disorder and military adversities such as emotional bullying, sexual harassment, and sexual assault during military service.
How is student behaviour and teachers’ perception impacted by the Implementation of Trauma Informed Schools on Children Who Have Experienced ACEs and Trauma?
The researcher found that when there are strong student-teacher relationships it predicts
student achievement, increased levels of engagement, and form the foundation of trauma informed interventions in the classroom. Teachers also used strategies themselves to stay calm
and centered by recognizing their own triggers, building relationships, and setting goals to
increase their own continued practice of being trauma informed. The research shows from
trauma-informed practices, students learn how to cope with their stress, how to respond to their
future stress, and understand how to trust others.
A recent paper published in this year found that when analysing the studies for teacher perceptions on being trauma-informed, the researcher found the following recurring themes: lack of knowledge, confidence, and training
and the importance of teacher wellbeing and burnout. The main focus was how the lack of trauma-informed training and resources was available and how that can be a source of teacher
stress by not being able to support the needs of adversity-affected students. Kim et al. (2021)
discussed teachers showing significant grown in trauma-informed attitudes. Using a newly acquired trauma lens, teachers had a heightened awareness and sensitivity to viewing rebellious classroom behavior and shifted their approach to responding appropriately. Results from Kim et al. (2021) show how trauma training impacted teacher knowledge of trauma and adversity and led to meaningful changes in viewing student behavior and responses to stress.
Existential Disruptions of Managers as a Collapse of Childhood Patterns: An Interpretative Phenomenological Investigation ial costs of adverse childhood experiences in 28 European countries: a systematic review and meta-analysis
In most countries, interpersonal violence had the largest PAFs due to ACEs (range 14·7–53·5%), followed by harmful alcohol use (15·7–45·0%), illicit drug use (15·2–44·9%), and anxiety (13·9%–44·8%). Harmful alcohol use, smoking, and cancer had the highest ACE-attributable costs in many countries. Total ACE-attributable costs ranged from $0·1 billion (Montenegro) to $129·4 billion (Germany) and were equivalent to between 1·1% (Sweden and Turkey) and 6·0% (Ukraine) of nations’ gross domestic products.
Background: The psychological impact of COVID-19 is multifaceted, both acute and chronic,
and has not affected everyone equally. Method: This longitudinal study compared those with and
without Adverse Childhood Experiences (ACEs) on measures of psychological distress and wellbeing
over time. Results: All groups (No ACE, Low ACE, and High ACE) had similar levels of distress at Time 1, with significant increases in psychological distress for those with ACEs over time, but not for those without. Psychological Flexibility was strongly and significantly associated with decreases in psychological distress and improved wellbeing. It significantly mediated the relationship between ACE and wellbeing. Conclusions: Those with ACEs report significantly increased psychological distress over time, compared to those without ACE during the COVID-19 pandemic. Evidence-based interventions using Psychological Flexibility may improve mental health and wellbeing to help further mediate its effects.