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PACEs Research Corner — August 2022, Part 1

 

[Editor's note: Dr. Harise Stein at Stanford University edits a web site —abuseresearch.info — that focuses on the effects of abuse, and includes research articles on PACEs. Every month, she posts the summaries of the abstracts and links to research articles that address only ACEs, PCEs and PACEs. Thank you, Harise!! — Jane Stevens]

Child Abuse

Theodorou CM, Brown EG, Jackson JE, Beres AL.
Child Abuse and the COVID-19 Pandemic. J Surg Res. 2022 Aug;276:18-23. PMID: 35325681
Of children 5 years or younger admitted to a level one pediatric trauma center during the pandemic 3/20-9/20, compared to one year prior, the rate of abuse/neglect did not statistically differ; however, during the pandemic discharge to a new caregiver was significantly lower (59.1% vs. 94.1%) as was foster care placement (22.7% vs. 50.0%). “While likely multifactorial, this data suggests that resources during COVID may have been limited and the clinical significance of this is concerning.”

Schønning V, Sivertsen B, Hysing M, Dovran A, Askeland KG.
Childhood maltreatment and sleep in children and adolescents: A systematic review and meta-analysis. Sleep Med Rev. 2022 Jun;63:101617. PMID: 35313257
A thorough research review showed significant associations between exposure to childhood maltreatment and insomnia symptoms (Odds Ratio 3.91), shorter sleep duration (-12.1 min) and nightmares (OR 3.15). “Our findings highlight the importance of screening and intervening for sleep problems in children and adolescents exposed to childhood maltreatment.”

Flomenbaum MA, Warner RC.
Morphologic Markers of Acute and Chronic Stress in Child Abuse. Am J Clin Pathol. 2022 Jun 7;157(6):823-835. PMID: 34919642
From autopsies of 3 cases of fatal child abuse, besides overwhelming physical injuries, all 3 had telogen effluvium, a form of stress hair loss; a markedly contracted thymus (immune system organ), a well-known marker of physiologic stress in children; and microscopic findings of myocardial necrosis (death of heart cells), associated with extremely high levels of stress hormones. “Pathologists are urged to explore these markers as supportive evidence in their own investigations of possible child abuse fatalities.”

Rabbitt AL, Olson NL, Liegl MN, Simpson P, Sheets LK.
Caregiver Reports of Infant Distress and Injury in Abused Infants. J Pediatr. 2022 Jun;245:190-195.e2. PMID: 35351533
In this retrospective case-controlled study, infants with medical encounters for “distress” were 2.6 times more likely to be subsequently seen with abuse injuries, and their caregivers “may benefit from intensive educational and support services.”

Pierce H, Jones MS, Holcombe EA.
Early Adverse Childhood Experiences and Social Skills Among Youth in Fragile Families. J Youth Adolesc. 2022 Aug;51(8):1497-1510. PMID: 35380397
In this study of fragile families, increasing ACEs before age 5 were associated with decreasing social skills at age 15 (social skills components included: emotional maturity, communication skills, intentionality, and social competence). Social skills developed in adolescence often persist into adulthood.

Adult Manifestations of Child Abuse

Smith GC, Dolbin-MacNab M, Infurna F, et. al.
Self-reported Adverse Childhood Experiences Among Custodial Grandmothers: Frequencies, Patterns, and Correlates. Int J Aging Hum Dev. 2022 Jun 16:914150221106096. PMID: 35711151
Of 355 custodial grandmothers (CGM), only 11% reported 0 ACEs, and 52.4% reporting >4. Predominant ACEs were bullying (54.6%), verbal abuse (51.5%), physical abuse (45.4%), and living with a substance abuser (41.1%). Different ACE profiles had unique impacts on CGMs’ physical and psychological well-being. “We conclude that ACEs are highly prevalent among CGMs and a serious public health concern. Future research addressing ACEs among CGMs is critical in order to support these caregivers and promote resilience in custodial grandfamilies.”

McElvaney R, McDonnell Murray R, Dunne S.
Siblings' Perspectives of the Impact of Child Sexual Abuse Disclosure on Sibling and Family Relationships. Fam Process. 2022 Jun;61(2):858-872. PMID: 34060077
In this small Irish study of the adult siblings of those who had experienced childhood sexual abuse, many participants found out about the abuse more than a decade after it happened (48%), 2% found out immediately, and an additional 9% found out within weeks or months afterwards. The mean age for participants when they found out was 26. The most typical way that respondents discovered the abuse was that their sibling told them (49%), followed by being told by other family members (11%) or someone outside the family (11%). The main themes that emerged from sibling interviews included intense emotional reaction and distress; change in the sibling relationship, reflecting either an increased closeness or an increased strain; and struggling to manage family dynamics as the impact of the abuse and subsequent disclosure influenced family relationships.

McCutchen C, Hyland P, Shevlin M, Cloitre M.
The occurrence and co-occurrence of ACEs and their relationship to mental health in the United States and Ireland. Child Abuse Negl. 2022 May 26;129:105681. PMID: 35643057
Comparing data on US and Irish adults, Irish respondents had a higher rate of ACEs; were more likely to experience specific ACEs; and were more likely to meet diagnostic requirements for major depressive disorder, generalized anxiety disorder, and complex PTSD (CPTSD) than U.S. respondents. Emotional neglect was more strongly related to mental health than all other ACEs, and there was an exceptionally strong dose-response association between ACEs and CPTSD.

Fung HW, Chien WT, Ling HW, Ross CA, Lam SKK.
The mediating role of post-traumatic stress disorder symptoms in the relationship between childhood adversities and depressive symptoms in two samples. Child Abuse Negl. 2022 Jun 14;131:105707. PMID: 35714440
From two online surveys of Chinese adults, the presence of PTSD symptoms influenced whether or not childhood abuse led to adult depression. “Our findings suggest that addressing unresolved PTSD symptoms for adults with childhood adversities may help in preventing or treating depressive symptoms.”

Wong RS, Tung KTS, Ho FKW, et. al.
Associations between childhood maltreatment and psychiatric disorders: analysis from electronic health records in Hong Kong.
Transl Psychiatry. 2022 Jun 6;12(1):231. PMID: 35668084
From a large study of Hong Kong young adults, “Childhood maltreatment exposure was significantly associated with subsequent diagnosis of conduct disorder/ oppositional defiant disorder (adjusted hazard ratio 10.99), attention deficit hyperactivity disorder (ADHD) (7.28), and personality disorders (5.36). The risk of psychiatric disorders following childhood maltreatment did not vary by age at maltreatment exposure, and gender.”

Vadukapuram R, Shah K, Ashraf S, et. al.
Adverse Childhood Experiences and Their Impact on Sleep in Adults: A Systematic Review. J Nerv Ment Dis. 2022 Jun 1;210(6):397-410. PMID: 35640064
From a research review, ACEs were associated with adult chronic short sleep duration (<6 hrs/night), as well as other poor sleep characteristics. Authors advocate for increased awareness of this factor in trauma care, and better education/training in patients for improved sleep.

Pérez-Balaguer A, Peñuelas-Calvo I, Alacreu-Crespo A, et. al.
Impulsivity as a mediator between childhood maltreatment and suicidal behavior: A systematic review and meta-analysis. J Psychiatr Res. 2022 Jul;151:95-107. PMID: 35477079
“Studies suggest that exposure to traumatic situations in childhood affects the proper neurobiological, cognitive, and affective development of individuals. This may increase impulsivity, which in turn would be related to an increased risk of suicide. The effects of childhood maltreatment and impulsivity may be both therapeutic targets of interest to reduce suicide rates.”

de Heer C, Bi S, Finkenauer C, Alink L, Maes M.
The Association Between Child Maltreatment and Loneliness Across the Lifespan: A Systematic Review and Multilevel Meta-Analysis. Child Maltreat. 2022 Jun 2:10775595221103420. PMID: 35652822
From a research review, “individuals with maltreatment histories, especially those who have been emotionally abused and/or emotionally neglected, are vulnerable to experiencing loneliness across the lifespan…feelings of loneliness warrant attention in prevention and intervention programs for individuals with maltreatment histories.”

Pereda N, Contreras Taibo L, Segura A, Maffioletti Celedón F.
An Exploratory Study on Mental Health, Social Problems and Spiritual Damage in Victims of Child Sexual Abuse by Catholic Clergy and Other Perpetrators. J Child Sex Abus. 2022 May-Jun;31(4):393-411. PMID: 35635066
Comparing adults from Spain and Chile who had been sexually abused as children by Catholic clergy, family members, and non-family members, many of the consequences to health and well-being were similar. However those abused by clergy had a “serious decline in their belief in God”, which was an important predictor for most subsequent mental health and social problems.

Mian O, Belsky DW, Cohen AA, et. al.
Associations between exposure to adverse childhood experiences and biological aging: Evidence from the Canadian Longitudinal Study on Aging. Psychoneuroendocrinology. 2022 Jun 3;142:105821. PMID: 35679774
From a Canadian aging study, most ACEs were mildly associated with increased biological (cellular) aging, however neglect was the most strongly associated with aging.

Leachman JR, Heier K, Lei F, et. al.
Sex and race define the effects of adverse childhood experiences on self-reported BMI and metabolic health biomarkers. Biol Sex Differ. 2022 Jun 15;13(1):29. PMID: 35706066
From a Southern Community cohort Study (2012-2015) with 60% Black subjects and mean age of 60 years, “BMI steadily increased with cumulative ACEs among Black and White women, but remained relatively stable in White men with ≥ 4 ACEs. Contrary, Black men showed an inverse association between ACE and BMI…Total cholesterol increased among individuals with more than 4 ACEs. In addition, increases in HbA1c [blood sugar] were associated with emotional and maternal abuse in Black women and sexual abuse in White women.”

Panisch LS, Rogers RG, Breen MT, et. al.
Childhood betrayal trauma, dissociation, and shame impact health-related quality of life among individuals with chronic pelvic pain. Child Abuse Negl. 2022 Jun 21;131:105744. PMID: 35749903
Of 96 women seen at a women’s health clinic for chronic pelvic pain, both dissociation and shame from “childhood betrayal trauma” negatively affected both mental and physical health-related quality of life.

Froelich J, Timko C, Woodhead EL.
Motives for substance use and 6-month substance use outcomes among detoxification patients with a history of physical or sexual abuse or post-traumatic stress disorder. J Trauma Stress. 2022 Jun;35(3):976-987. PMID: 35255172
Of 298 detoxified veterans (alcohol, opioids, or both), those with a past history of physical abuse, sexual abuse, and diagnosed PTSD were all associated with high scores on risk factors for relapse. “Detoxification patients with physical and/or sexual abuse histories or PTSD diagnoses may need treatments that better address trauma symptoms to help them sustain abstinence.”

Jacobsen AL, Madsen T, Ranning A, et. al.
Level of Suicidal Ideation Among Callers to the Danish Suicide Prevention Helpline. Arch Suicide Res. 2022 Jun 15:1-16. PMID: 35703206 Among 42,393 answered calls to a Danish suicide prevention helpline, 37% were considered high risk for suicide compared to 1.5% general population. Being a woman, of younger age, having a history of previous suicide attempt as well as experiencing problems related to self-harm, mental disorders, eating disorders, incest, sexual assault, substance abuse, and physical health problems was associated with risk of suicide.

Prentice DM, Otaibi BW, Stetter C, Kunselman AR, Ural SH.
The Association Between Adverse Childhood Experiences and Postpartum Depression. Front Glob Womens Health. 2022 May 26;3:898765. PMID: 35692946
Of 251 women with postpartum depression (PPD) 2015-2019, surveyed at an academic medical center with a 53% response rate, only 19.3% reported 0 ACEs, while 34.1% had 4+ ACEs. “Women with PPD are more likely to have high-risk ACE scores than the general female population [essentially these 2 numbers are reversed in the general female population]. This finding has important implications in regards to counseling.”

Murphy D, Turgoose D.
Childhood adversity and mental health in veterans seeking treatment for mental health difficulties: Comparisons with the general military population. Psychol Trauma. 2022 Jul;14(5):805-811. PMID: 31868375
Of 403 UK veterans seeking treatment for mental health difficulties, 44% reported 6+ ACEs (vs 24% in the general military population). “Many participants reported drug and alcohol misuse or domestic violence between parents. PTSD, anger, and brain injury were all related to high childhood adversity.”

Adolescents

Chaplo S, Fishbein D.
Capitalizing on Neuroplasticity Across Development to Redirect Pathways from Juvenile Justice Involvement. Curr Top Behav Neurosci. 2022;53:235-254. PMID: 34486099
“Adolescence is an exquisitely sensitive period of development during which pathways branch toward success in school and prosocial pursuits or, conversely, toward behavior problems and involvement in high-risk activities and systems, such as juvenile justice (JJ)… evidence is summarized of how neurodevelopmental pathways may lead to JJ involvement. Because neurodevelopment is malleable…there is potential for well-targeted interventions to normalize brain and cognitive development, especially during sensitive periods of maturation.” A research agenda for these interventions is proposed.

Draxler JM, Ruppar TM.
Treatment Adherence in Adolescents With Histories of Adverse Childhood Experiences: A Systematic Review. J Psychosoc Nurs Ment Health Serv. 2022 Jun;60(6):11-18. PMID: 34846229
From a research review, “Treatment adherence was most often defined as some form of attendance in a treatment program. Results support a relationship between ACEs and treatment nonadherence in adolescents. ACEs related to maltreatment, particularly emotional abuse, may be more predictive of treatment nonadherence than other types of ACEs.”

Lewis-de Los Angeles WW.
Association between adverse childhood experiences and diet, exercise, and sleep in pre-adolescents. Acad Pediatr. 2022 Jun 18:S1876-2859(22)00300-X. PMID: 35728730
From a national study of 10-11 year-olds, ACEs in pre-adolescents showed a dose-response relationship with unhealthy diet and sleep disruption, but no effect on exercise.

Pammenter A, Woodford EL, Harris DA.
Adverse childhood experiences in Australian youth adjudicated for sexual offences and non-sexual violent offences. Child Abuse Negl. 2022 Jun 5;129:105678. PMID: 35675724
“This study examines the differential childhood adversities experienced by two samples of Australian adolescents involved in the juvenile justice system: male youth who had been adjudicated for sexual offences and those adjudicated for nonsexual violence. Male youth who had committed a sexual offence were more likely than their counterparts to have experienced emotional and sexual abuse and neglect in their childhoods. Alternatively, the childhoods of the comparison group were marked by characteristics of more general household dysfunction.”

Karamanos A, Stewart K, Harding S, Kelly Y, Lacey RE.
Adverse childhood experiences and adolescent drug use in the UK: The moderating role of socioeconomic position and ethnicity. SSM Popul Health. 2022 Jun 14;19:101142. PMID: 35733836
From a national UK study, “ACEs are associated with adolescent drug use with potential consequences on wider aspects of young people's lives, regardless of their social, ethnic, or economic background…No evidence was found that either advantaged socio-economic position or ethnicity acted as a buffer against the negative effects of ACEs in relation to adolescent drug use.”

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