[Editor's note: Dr. Harise Stein at Stanford University edits a web site — abuseresearch.info — that focuses on the health effects of abuse, and includes research articles on ACEs. Every month, she posts the summaries of the abstracts and links to research articles that address only ACEs. Thank you, Harise!! -- Jane Stevens]
CHILD ABUSE
Panisch LS, Baiden P, Findley E, Jahan N, LaBrenz CA.
Examining the Association Between Adverse Childhood Experiences and Asthma Among Children in the United States: The Intersection of Sex and Race/Ethnicity. J Asthma. 2021 Mar 30:1-15. PMID: 33783306
Of 49,000 children aged 0-17 years, 11.5% of children had asthma, 42% had at least one ACE, and 9.7% had 3+ ACEs. Controlling for other factors, children with 3+ ACEs had 1.45 times higher odds of having asthma compared to children with no ACEs. There was also a sex and race/ethnicity effect, with increases for males and Black children.
Hawkins MAW, Layman HM, Ganson KT, et. al.
Adverse childhood events and cognitive function among young adults: Prospective results from the national longitudinal study of adolescent to adult health. Child Abuse Negl. 2021 May;115:105008. PMID: 33706023
From a large national survey, “Higher ACEs, especially deprivation-type, were prospectively linked to poorer cognition [immediate and delayed verbal memory, and working memory]. Early wide-scale screening/tailored treatments addressing ACEs and cognitive function may be warranted.”
ADULT MANIFESTATIONS
Craner JR, Lake ES.
Adverse Childhood Experiences and Chronic Pain Rehabilitation Treatment Outcomes in Adults. Clin J Pain. 2021 May 1;37(5):321-329. PMID: 33830091
Of 269 adults participating in an interdisciplinary pain rehabilitation program, 78.5% reported at least 1 ACE, and 43% 3+ ACEs. Those with 3+ ACEs reported more mental health symptoms and difficulties in adjusting to chronic pain, however all ACE groups improved and there were no differences in response to treatment. “This model of treatment may be especially well situated to address the biopsychosocial contributions to pain among those with a history of adversity.”
Tang S, Jones CM, Wisdom A, Lin HC, Bacon S, Houry D.
Adverse childhood experiences and stimulant use disorders among adults in the United States. Psychiatry Res. 2021 Mar 13;299:113870. PMID: 33780857
From a large national study, authors found a strong relationship between increasing ACE exposures and stimulant use and use disorders (amphetamine-type stimulants and cocaine).
RACISM
Giovanelli A, Reynolds AJ.
Adverse childhood experiences in a low-income black cohort: The importance of context. Prev Med. 2021 Apr 12:106557. PMID: 33857559
For a group of Black Chicago youth followed since 1980, rates of ACEs-C [conventional ACEs] increased over the course of childhood and adolescence, with higher rates of ACEs-E [expanded ACEs] including family financial problems; witness or victim of violent crime; death of a parent, relative or close friend; and out of home placement] reported by males. 1/5 of participants only reported ACEs-E, which are often not measured. “ACEs can have enduring impacts, but it is difficult to illuminate prevention and intervention strategies if adversity is not accurately assessed. Findings support the need for novel, comprehensive tools for measurement of adversity, particularly in impoverished settings.”
PROVIDERS
Williams WA 2nd, Jain M, Laguna TA, McColley SA.
Preferences for disclosing adverse childhood experiences for children and adults with cystic fibrosis. Pediatr Pulmonol. 2021 May;56(5):921-927. PMID: 33369260From a survey of parents (29% participation) and their adult children with cystic fibrosis (34% participation) at a university cystic fibrosis center, only 22% of parents and 17% of adults were willing to disclose specific ACEs, 57% of parents and 47% of adults were willing to disclose total number of ACEs, 76% of parents and 67% of adults were willing to participate in anonymous research about ACEs, and 63% of parents and 50% of adults would prefer ACEs screened separately from medical appointments.
Corona LE, Akselberg NJ, Stork BR.
Comment on "The Association Between Adverse Childhood Experiences and Burnout in a Regional Sample of Physicians". Acad Psychiatry. 2021 Jun;45(3):399-400. PMID: 33851340
In a letter to the editor commenting on a prior article showing an association between physician burnout and number of Adverse Childhood Experiences (ACEs), these authors note their similar study, unpublished, that showed a similar association between physician ACEs and burnout, but only for 3 specific ACEs: were routinely insulted or afraid (bullied), felt unloved or supported, or lived with a mentally ill household member.
Williams BW, Welindt D, Hafferty FW, et. al.
Adverse Childhood Experiences in Trainees and Physicians With Professionalism Lapses: Implications for Medical Education and Remediation. Acad Med. 2021 May 1;96(5):736-743. PMID: 32520753
Of 123 cases of US trainees and physicians who had been referred to a center for professionalism issues (boundary violation, disruptive behavior, or potential substance use disorder), 70% reported at least 1 ACE, and 22% reported 4+ ACEs, both higher than the general public. “Remediating individuals with professionalism issues and exposure to ACEs can be complicated by heightened responses to stressful stimuli, difficulties with collaboration and trust, and decreased self-efficacy [belief in one’s ability to successfully manage life situations].”
PREVENTION
Narayan AJ, Lieberman AF, Masten AS.
Intergenerational transmission and prevention of adverse childhood experiences (ACEs). Clin Psychol Rev. 2021 Apr;85:101997. PMID: 33689982
“Part I of this review applies risk and resilience concepts to pathways of intergenerational ACEs, highlighting parental PTSD symptoms as a key mediator, and promotive or protective processes that buffer children against intergenerational risk. Part II examines empirical findings indicating that parents' positive childhood experiences counteract intergenerational ACEs. Part III recommends clinically-sensitive screening of ACEs and positive childhood experiences in parents and children. Part IV addresses tertiary prevention strategies that mitigate intergenerational ACEs and promote positive parent-child relationships.”
OTHER OF INTEREST
Rodriguez CM, Lee SJ, Ward KP, Pu DF.
The Perfect Storm: Hidden Risk of Child Maltreatment During the Covid-19 Pandemic. Child Maltreat. 2021 May;26(2):139-151. PMID: 33353380
In two pandemic-related studies, parents reported increased parent-child conflict, which contained concurrent child abuse and neglect risk, and which were associated with parental perceived stress, loneliness, employment loss, and food insecurity. “Findings are discussed in the context of a reactive welfare system rather than a pro-active public-health oriented approach to child maltreatment.”
Ehrlich KB, Miller GE, Rogosch FA, Cicchetti D.
Maltreatment exposure across childhood and low-grade inflammation: Considerations of exposure type, timing, and sex differences. Dev Psychobiol. 2021 Apr;63(3):529-537. PMID: 32896910
Of 155 low-income children aged 8-12, half of whom had been exposed to maltreatment, blood samples showed that maltreatment exposure was associated with higher inflammation for girls but not boys, and greater for those girls who experienced maltreatment across multiple time points. Highest inflammation was found for girls whose first maltreatment onset was before age 5.
Puetz VB, Viding E, Gerin MI, et. al.
Investigating patterns of neural response associated with childhood abuse and childhood neglect. Psychol Med. 2020 Jun;50(8):1398-1407. PMID: 31190662
Compared to a control group, brain scans of adults who experienced abuse showed increased reactivity in a particular area of the brain involving emotions such as fear, whereas those who experienced neglect showed increased reactivity more widely in parts of the brain dealing with complex social and thought processing. Unexpectedly, those with a history of both abuse and neglect showed decreased activity in both thinking and emotion areas of the brain.
Rentscher KE, Carroll JE, Mitchell C.
Psychosocial Stressors and Telomere Length: A Current Review of the Science. Annu Rev Public Health. 2020 Apr 2;41:223-245. PMID: 31900099T
horough review of research and research quality on various psychosocial factors associated with telomere length. The strongest association was found between poorer socioeconomic status and early life adversity and shortened adult TL.
Nguyen JK, Thurston RC.
Association of Childhood Trauma Exposure with Inflammatory Biomarkers Among Midlife Women. J Womens Health (Larchmt). 2020 Dec;29(12):1540-1546. PMID: 32364816
For 304 nonsmoking women aged 40-60, and controlling for many factors, childhood emotional abuse was associated with higher levels of IL-6 (a blood marker of inflammation).
Mundi MS, Hurt RT, Phelan SM, et. al.
Associations Between Experience of Early Childhood Trauma and Impact on Obesity Status, Health, as Well as Perceptions of Obesity-Related Health Care. Mayo Clin Proc. 2021 Feb;96(2):408-419. PMID: 33549259
From a national survey, respondents reporting being a victim of childhood abuse increased significantly with increasing levels of obesity. Obese patients with a history of childhood abuse also reported lower self-esteem, feeling more judged, and less treated with respect by their health care providers.
Stickley A, Waldman K, Sumiyoshi T, et. al.
Childhood physical neglect and psychotic experiences: Findings from the National Comorbidity Survey Replication. Early Interv Psychiatry. 2021 Apr;15(2):256-262. PMID: 32048480
From a large national survey, childhood physical neglect was associated with significantly increased odds of lifetime psychotic episodes (losing touch with reality) in the general population, especially for being unsupervised, going without medical care, or doing chores that were too difficult/dangerous.
Etain B, Aas M.
Childhood Maltreatment in Bipolar Disorders. Curr Top Behav Neurosci. 2021;48:277-301. PMID: 32653999
“We will review how childhood maltreatment and trauma not only predispose to the development of bipolar disorder but also to a more unstable, pernicious, and severe clinical expression of the disorder…We will also review how childhood maltreatment may modify the brain functioning and circuits and alter some biological pathways.”
Stafford L, Harkin JA, Rolfe A, Burton J, Morley C.
Why having a voice is important to children who are involved in family support services. Child Abuse Negl. 2021 May;115:104987. PMID: 33725537
“Emergent themes that the study identified, namely: each child has their own unique knowledge and insights; children are part of the family so they should be recognized and should have a say; expressing their needs leads to them and their families getting required help and support; children gain agency through feeling valued and listened to.”
Austin JM, Weeks K, Pronovost PJ.
Health System Leaders' Role in Addressing Racism: Time to Prioritize Eliminating Health Care Disparities. Jt Comm J Qual Patient Saf. 2021 Apr;47(4):265-267. PMID: 33339750
Per authors, key steps that health system leaders should take to identify and eliminate health care disparities include: to recognize that health care disparities exist in every health system and are system failures that occur at many levels, similar to other quality gaps that require system-based fixes; to declare that this work is important and that leadership will be held accountable; to be transparent with disparities and report them as part of their standard set of quality metrics; and to commit to increasing the diversity of senior leadership and those on the front lines.
Roubinov D, Bush NR, Boyce WT.
How a Pandemic Could Advance the Science of Early Adversity. JAMA Pediatr. 2020 Dec 1;174(12):1131-1132. PMID: 32716499
Authors note that the pandemic could “aid in developing and implementing evidence-based practices that reduce risk and promote resilience within vulnerable families.” While the trauma and unpredictability of the pandemic has added to stressors, many families will also display resilience. Disruption of routines have exposed the importance of factors such as internet access for education; safe, walkable stress and recreational spaces; cross-generational support and childcare; and access to mental health and substance use counseling. Authors suggest that researchers as well as healthcare and community stakeholders may want to take this opportunity to: measure pandemic exposure and disruptions; conduct longitudinal assessments; measure resilience-promoting factors and positive adjustment; assess biological factors; consider the complexity of pandemic-induced consequences; measure caregiver mental health and functioning; collect data that foster the recognition and discussion of health disparities; evaluate prevention and intervention efforts; foster collaborations within the research community; and consider feasible, sensitive, and nonintrusive data collection methods.
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