[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
Gaylord NM, Bland T, Munoz L, Ross R, Olson C.
Prevalence and Impact of Adverse Childhood Experiences in an Interdisciplinary, School-Based Pediatric Clinic. J Pediatr Health Care. 2022 Mar-Apr;36(2):e1-e10. PMID: 35227420
Of 1,028 children seen at a school-based, interprofessional clinic over 1 academic year, “Nearly 58% of children had at least one ACE, and 9.5% had four or more, similar to the prevalence of ACEs in adults. With increasing ACEs, children had higher rates of intrauterine drug exposure, intensive care on delivery, homelessness, substance abuse, behavioral problems, mental illness, learning difficulties, and weight issues.”
Price JH, Khubchandani J.
Childhood Suicide Trends in the United States, 2010-2019. J Community Health. 2022 Apr;47(2):232-236. PMID: 34668128
From CDC data 2010-2019 for US children 12 years of age and younger, “Child suicides statistically significantly increased for black (95%), white (158%), male (95%), and female (300%) children during the decade.” Methods children used to commit suicide did not significantly differ by race or gender, with the leading method strangulation/suffocation (67%-85%), and the second most common by the use of a firearm (11%-30%). “Northeastern states had the fewest child suicides during the decade and Texas and California had the most child suicides.”
Price JH, Khubchandani J.
Hispanic Child Suicides in the United States, 2010-2019. J Community Health. 2022 Apr;47(2):311-315. PMID: 34997530
Using national data 2010-2019 for Hispanic children younger than 12 years of age, suicide is the 7th leading cause of death for Hispanic children, and significantly increased during the decade from 2010 to 2019 by 92.3%. “Suicide deaths were primarily in boys (59.6%) and among those 10-12 years of age (94.9%). Hispanic child suicides were most common in the West and South and least common in the Northeastern US. The method used to commit suicide was overwhelmingly (76-85%) hanging/strangulation/suffocation.”
Offerman ECP, Asselman MW, Bolling F, et. al.
Prevalence of Adverse Childhood Experiences in Students with Emotional and Behavioral Disorders in Special Education Schools from a Multi-Informant Perspective. Int J Environ Res Public Health. 2022 Mar 14;19(6):3411. PMID: 35329097
Of 169 Dutch students mean age 11.58 years, 85.1% boys, from 5 schools for children with emotional and behavioral disorders, 96.4% self-reported 1 ACE (89.5% parent reports, 95.4% school files), and 74.5% 4+ACEs (62.7% parents, 59.9% school files). 45.9% of the students experienced their first ACE before the age of 4.
Birkeland MS, Skar AS, Jensen TK.
Understanding the relationships between trauma type and individual posttraumatic stress symptoms. J Child Psychol Psychiatry. 2022 Mar 18. PMID: 35304778
Of 4,921 children and adolescents referred to mental health services, “Sexual trauma, domestic violence and severe bullying or threats were associated with higher levels of PTSS [post-traumatic stress symptoms]…Across all trauma types, reactivity to trauma reminders, avoidance, and difficulties with sleeping and concentrating were the most frequent symptoms.”
Finkelhor D, Turner H, LaSelva D.
Medical Treatment Following Violence Exposure in a National Sample of Children and Youth. JAMA Netw Open. 2021 May 3;4(5):e219250. PMID: 33978721
From a national survey of 8503 children and youth, 3.4% had a lifetime violence-related medical visit and 1.9% in the past year, equivalent to approximately 1.4 million children and youth, 33.3% of whom were aged 2 to 9 years. Those with a past-year visit had higher levels of trauma symptoms (risk ratio, 1.71), ACEs (2.55) and multiple violence exposures (3.91) compared with the general sample. “The estimated large number of violence-related visits with medical professionals offers an opportunity to address a source of frequent injury, and provide counseling and referral.”
Adult Manifestations of Child Abuse
Naicker SN, Ahun MN, Besharati S, et. al.
The Long-Term Health and Human Capital Consequences of ACEs in the Birth to Thirty Cohort. Int J Environ Res Public Health. 2022 Feb 5;19(3):1799. PMID: 35162821
“Human capital--that is the cumulative abilities, education, social skills, and mental and physical health one possesses--is increasingly recognized as key to the reduction of inequality in societies.” Adverse childhood experiences have been linked to a range of human capital…negative outcomes in young adulthood.”
Souch AJ, Jones IR, Shelton KHM, Waters CS.
Maternal childhood maltreatment and perinatal outcomes: A systematic review.
J Affect Disord. 2022 Apr 1;302:139-159. PMID: 35041871
From a research review, maternal childhood maltreatment (MCM) was consistently associated with difficulties in maternal and infant emotional regulation and with disturbances in the mother-infant relationship, often influenced by mothers' current mental health. “Direct and mediated associations between MCM and adverse pregnancy and obstetric outcomes were suggested by a limited number of studies. Emotional and sexual abuse were the most consistent MCM subtype significantly associated with adverse perinatal outcomes.”
Brunton R, Wood T, Dryer R.
Childhood abuse, pregnancy-related anxiety and the mediating role of resilience and social support. J Health Psychol. 2022 Mar;27(4):868-878. PMID: 33153340
For 638 pregnant women, total childhood abuse (and all types independently), were related to higher pregnancy-related anxiety scores than women without a childhood maltreatment history. Personal levels of resilience and higher social support decreased anxiety.
Saygideger Y, Özkan H, Baydar O, Yilmaz O.
Adulthood asthma as a consequence of childhood adversity: a systematic review of epigenetically affected genes. J Dev Orig Health Dis. 2022 Mar 8:1-9. PMID: 35256035
From a research review, “Several genes and pathways that may contribute to pathogenesis of asthma development, increased inflammation, or response to asthma treatment were found epigenetically affected by childhood traumas. Childhood adversity, causing epigenetic changes in DNA, may lead to asthma development or influence the course of the disease.”
Strenth CR, Mo A, Kale NJ, et. al.
Adverse Childhood Experiences and Diabetes: Testing Violence and Distress Mediational Pathways in Family Medicine Patients. J Interpers Violence. 2022 Feb 27:8862605221076536. PMID: 35225043
Of 581 adults with type 2 diabetes seen in seven family medicine clinics, in 58.3% their diabetes was not in control. Even after controlling for several variables, ACE score was associated with increased positive IPV screen, which was associated with increased emotional burden, which was then associated with a decrease in diabetes control.
Lipsky RK, McDonald CC, Souders MC, et. al.
Adverse childhood experiences, the serotonergic system, and depressive and anxiety disorders in adulthood: A systematic literature review. Neurosci Biobehav Rev. 2022 Mar;134:104495. PMID: 34919986
Very detailed, technical review of what we know to date about the serotonergic system (one brain hormone system that has to do with mood), associated depressive and anxiety disorders, various genetic (inherited) and epigenetic (influences from the environment such as ACEs) changes to this system, and the resulting impact on the efficacy of different types of anti-depressant medication.
Grimbergen C, Fassaert T.
Occurrence of Psychiatric Disorders, Self-Sufficiency Problems and Adverse Childhood Experiences in a Population Suspected of Violent Extremism. Front Psychiatry. 2022 Feb 15;13:779714. PMID: 35242062
From detailed reports on 34 adult violent extremists in Amsterdam, 29.4% experienced mood and anxiety disorders, 29.4% mild intellectual disability, 35.3% substance use disorder, 41.2% personality disorder, 14.7% psychotic disorders, and 35.3% had been exposed to 4+ ACEs. Most common ACEs were emotional neglect (47.1%), household mental illness (44.1%), and loss of a parent (38.2%).”
Carlyle M, Broomby R, Simpson G, et. al.
A randomised, double-blind study investigating the relationship between early childhood trauma and the rewarding effects of morphine. Addict Biol. 2021 Nov;26(6):e13047. PMID: 34155732
Physically healthy participants with either a history of severe childhood trauma or no previous history of childhood trauma attended two sessions where they received 2 different doses of morphine. “The trauma group reported liking the effects of morphine, feeling more euphoric and wanting more of the drug over the session, as well as feeling less nauseous, dizzy, and dislike of the effects of morphine compared to the non-trauma comparison group…Childhood trauma may therefore sensitise individuals to the pleasurable and motivational effects of opioids and reduce sensitivity to the negative effects, providing compelling evidence for opioid reward sensitivity. This may explain the link between childhood trauma and vulnerability to opioid use disorder.”
Cay M, Gonzalez-Heydrich J, Teicher MH, et. al.
Childhood maltreatment and its role in the development of pain and psychopathology. Lancet Child Adolesc Health. 2022 Mar;6(3):195-206. PMID: 35093193
“In this Review, we propose a biobehavioural framework in which childhood maltreatment and the associated aberrant neurobiological mechanisms and behavioural processes additionally lead to the onset of altered pain processing and, ultimately, the existence of pain syndromes… We have proposed that experiencing childhood maltreatment is a root cause of both psychiatric and pain-related symptoms...Several clinical instruments and research methods can be used to better understand pain or pain phenotypes in individuals who have experienced childhood maltreatment.”
Nelles-McGee T, Khoury J, Kenny M, Joshi D, Gonzalez A.
Biological embedding of child maltreatment: A systematic review of biomarkers and resilience in children and youth. Psychol Trauma. 2022 Apr;14(S1):S50-S62. PMID: 34881944
Summary of the state of research on the effects of child maltreatment on telomere length (a measure of cell aging) and DNA methylation (a measure of of the effects of environment on DNA), and the importance of resilience factors in mitigating risk.
Banihashemi L, Peng CW, Verstynen T, et. al.
Opposing relationships of childhood threat and deprivation with stria terminalis white matter. Hum Brain Mapp. 2021 Jun 1;42(8):2445-2460. PMID: 33739544
For 100 young adults with a full distribution of maltreatment history and mood symptom severity, threat (measured by childhood abuse and traumatic experiences), and deprivation (measured by childhood socioeconomic status) each created measurable and opposing influences on the structural integrity of certain brain “white matter” fibrous tracts responsible for communication between brain areas, “providing new evidence that the context of childhood adversity may have an important influence on its neurobiological effects, even on the same structure.”
Jasthi DL, Nagle-Yang S, Frank S, Masotya M, Huth-Bocks A.
Associations Between Adverse Childhood Experiences and Prenatal Mental Health and Substance Use Among Urban, Low-Income Women. Community Ment Health J. 2022 Apr;58(3):595-605. PMID: 34184153
Of 98 low-income pregnant women with mean age 25.4 years referred for mental health care, and controlling for marital status, education, and age, “Findings indicate high levels of childhood adversity, specifically childhood abuse, are associated with negative perinatal mental health and substance use outcomes, including suicidal thoughts, anxiety, mood dysregulation, and tobacco and marijuana use. Inquiring about ACEs during prenatal care may help identify patients' overall risk and provide opportunities for intervention.”
Salokangas RKR.
Emotional neglect in childhood is common and associates with adult mental ill health. Nord J Psychiatry. 2022 Mar 23:1. PMID: 35318883
In this survey of Finnish individuals from the general population, primary care clinics, and psychiatric outpatient clinics, the most frequently cited childhood adverse experience for all groups was emotional neglect. In the general population emotional neglect was associated with “people had a negative attitude towards them”, and in the medical and psychiatric populations emotional neglect had negative effects on depression, anxiety, and substance use.
Nichter B, Tsai J, Pietrzak RH.
Prevalence, correlates, and mental health burden associated with homelessness in U.S. military veterans. Psychol Med. 2022 Mar 18:1-11. PMID: 35301973
“Homelessness is a major public health problem among U.S. military veterans.” From a 2019-2020 survey of 4069 veterans, one in ten U.S. veterans has experienced homelessness, with more than 80% reported their first episode of homelessness following military service a mean of 10.6 years post-discharge. Veterans with a history of homelessness had elevated odds of lifetime suicide attempts, PTSD, major depression, generalized anxiety, and drug use disorders. “ACEs were the strongest factor associated with homelessness, thus underscoring the importance of targeting early childhood adversities and their mental health consequences in prevention efforts for homelessness in this population.”
Sinko L, Hughesdon K, Grotts JH, Giordano N, Choi KR.
A Systematic Review of Research on Trauma and Women's Health in the Nurses' Health Study II. Nurs Womens Health. 2022 Feb 28:S1751-4851(22)00039-3. PMID: 35240108
The Nurses’ Health Study II, begun in 1989, is among the largest prospective investigations into risk factors for major chronic diseases in women. “Interpersonal trauma across the life course was strongly associated with many leading causes of morbidity and mortality among female nurses…Results from a small number of studies suggested a negative intergenerational impact of trauma on the children of women in the NHS II…future investigations should leverage the full range of trauma measures available in the NHS II data set.”
Brokke SS, Bertelsen TB, Landrø NI, Haaland VØ.
The effect of sexual abuse and dissociation on suicide attempt. BMC Psychiatry. 2022 Jan 10;22(1):29. PMID: 35012509
Of 97 Norwegian acute psychiatric patients with suicidal ideation, of whom 32 had experienced [lifetime] sexual abuse, “Patients who had experienced sexual abuse reported higher levels of dissociation and were younger at onset of suicidal thoughts, more likely to self-harm, and more likely to have attempted suicide; and they had made more suicide attempts.” Dissociative experiences were significantly related to increasing number of suicide attempts, especially more than 4 attempts.
Adolescents
Kirsch DE, Lippard ETC.
Early life stress and substance use disorders: The critical role of adolescent substance use. Pharmacol Biochem Behav. 2022 Feb 25;215:173360. PMID: 35219756
Authors discuss the impact of early life stress (ELS) on the adolescent developing brain and stress hormone system, including the stress response, the brain reward system, and executive control (decision making and impulse control); and how brain changes following ELS and adolescent substance use may independently, additively, or interactively contribute to risk for addiction.”
Noudali SN, Patock-Peckham JA, Berberian SL, et. al.
Does insomnia mediate the link between childhood trauma and impaired control over drinking, alcohol use, and related problems? Addict Behav Rep. 2021 Dec 21;15:100402. PMID: 35036516
For 941 college students, “Higher levels of childhood emotional abuse were directly associated with more insomnia…and impaired control over drinking…We suggest that insomnia may contribute to dysregulated drinking and could be a promising therapeutic target of intervention among college student social drinkers.”
LGBTQ+ Concerns
Schnarrs PW, Stone AL, Bond MA, et. al.
Development and psychometric properties of the sexual and gender minority adverse childhood experiences (SGM-ACEs): Effect on sexual and gender minority adult mental health. Child Abuse Negl. 2022 Feb 26;127:105570. PMID: 35231816
Authors discuss the need for and development of a sexual/gender minority specific ACEs measure with 7 questions. Results showed adequate to good prediction for depression, anxiety, and PTSD.
Hughes PM, Ostrout TL, Pèrez Jolles M, Thomas KC.
Adverse Childhood Experiences Across Birth Generation and LGBTQ+ Identity, 2019. Am J Public Health. 2022 Apr;112(4):662-670. PMID: 35319940
The odds of experiencing 4+ ACEs were higher for Generation X (odds ratio 1.67), millennials (OR 2.12), and Generation Z (2.12) than for baby boomers. “This disparity was amplified by LGBTQ+ identity.” (Graph shows weighted percentage of those with 4+ ACEs.)
Race/Cultural Concerns
Sundaresh R, Yi Y, Harvey TD, et. al.
Exposure to Family Member Incarceration and Adult Well-being in the United States. JAMA Netw Open. 2021 May 3;4(5):e2111821. PMID: 34047791
“More than half of the adult population in the United States has ever had a family member incarcerated, an experience more common among Black individuals.” From a nationally representative survey of 2815 adults, 45.0% reported having an immediate family member who was incarcerated. Compared with respondents with no family incarceration, any family member incarceration was associated with lower well-being overall and in every individual domain, and with a mean estimated 2.6 years shorter life expectancy. Among those with any family incarceration, Black respondents had a mean estimated 0.46 fewer years of life expectancy compared with White respondents.
Bowen FR, Lewandowski LA, Snethen JA, et. al.
A Schema of Toxic Stress Informed by Racism, Transgenerational Stress, and Disadvantage. J Pediatr Health Care. 2022 Mar-Apr;36(2):79-89. PMID: 34627667
Authors propose a framework for the relationships between multiple sources of toxic stress, including the pandemic.
Bernard DL, Smith Q, Lanier P.
Racial discrimination and other adverse childhood experiences as risk factors for internalizing mental health concerns among Black youth. J Trauma Stress. 2022 Apr;35(2):473-483. PMID: 34800051
From a subsample of Black children mean age 9.8 years from the National Survey of Children’s health, and after controlling for other ACEs and sociodemographic variables, racial discrimination was significantly associated with youth diagnoses of depression (adjusted odds ratio 1.35) and anxiety (AOR 1.39). “The findings demonstrate that racial discrimination is comparably associated with youth internalizing problems relative to ACEs conventionally examined within the childhood trauma literature.”
Providers
Austin AE.
Screening for Traumatic Experiences in Health Care Settings: A Personal Perspective From a Trauma Survivor. JAMA Intern Med. 2021 Jul 1;181(7):902-903. PMID: 33938929
“’Do you have a history of emotional, physical, and/or sexual abuse? If so, please describe.’ In my early 20s, I started checking “yes.” Checking this box was the first time I disclosed to anyone that I had been sexually abused as a child… For more than a decade, I have consistently indicated on screeners that I was sexually abused as a child. Not once have I received any form of follow-up…Disclosing this information was a significant moment in my life, and the lack of follow-up reinforced my fears…A key tenet of public health and medical ethics is that screening without readily available and accessible evidence-based interventions, let alone a compassionate conversation, is unethical…it can retraumatize survivors and create hesitancy to seek help in the future.”
Finkelhor D, Berliner L.
Screening for Traumatic Childhood Experiences in Health Care Settings. JAMA Intern Med. 2021 Jul 1;181(7):903-904. PMID: 33938931
In an invited commentary to the article above, authors note the pitfalls and lack of evidence for outcomes and follow-up of screening, as well as more optimal approaches: It is less important to get details about the experience than to inquire about its possible implications for care and referral, for example, with an open-ended question such as, “What is it important for me as your health care professional to know about this?” Adequate discussion time may be needed…Patients with such histories may also have discomfort around certain aspects of medical care such as undressing, touch, and positioning and need to be given advanced warnings and options. In an ideal process, the infrastructure behind a fully comprehensive response would include training for health care professionals; having available informational resources such as pamphlets, videos, or websites; and the preplanning of a referral procedure.”
Blickenstaff HR, Bastin TJ, Byram JN.
Exploring Resilience Factors in Medical Students with Adverse Childhood Experiences: a Pilot Study. Acad Psychiatry. 2022 Apr;46(2):218-222. PMID: 34845708
Of 1440 medical students invited to an online survey that included an ACE survey, 5% completed the ACE portion. Mean ACE score was 1.69, with 19% experiencing 4+ ACEs. Five students with 4+ ACEs agreed to interviews, and revealed 4 protective and resilience factors: non-parental support, role models, volunteering, and use of mental health services.
Shenk CE, Keeshin B, Bensman HE, Olson AE, Allen B.
Behavioral and pharmacological interventions for the prevention and treatment of psychiatric disorders with children exposed to maltreatment. Pharmacol Biochem Behav. 2021 Dec;211:173298. PMID: 34774585
“The current review describes the most effective, well-researched, and widely-used behavioral and pharmacological interventions for preventing and treating a range of psychiatric disorders common in children exposed to maltreatment. Detailed descriptions of each intervention, including their target population, indicated age range, hypothesized mechanisms of action, and effectiveness demonstrated through randomized controlled trials research, are presented. Current limitations of these interventions are noted.”
Osei A, Paz CG, Stuparich M, et. al.
Screening for Toxic Stress Response and Buffering Factors: A Case-Based, Trauma-Informed Approach to Health Equity. MedEdPORTAL. 2022 Mar 4;18:11224. PMID: 35321319
Description of an “e-learning module that demonstrated the impact of ACEs by introducing students to screening for toxic stress response and buffering factors on health, their role as health equity determinants, and the use of brief in-clinic resilience-fostering tools in patient care.” Slides, facilitator guide and handouts
Lev-Wiesel R, Goldner L, Daphna-Tekoah S.
Introduction to the Special Issue: The Use of Creative Art Therapies in the Prevention, Screening, and Treatment of Child Sexual Abuse. J Child Sex Abus. 2022 Jan;31(1):3-8. PMID: 35081876“
The significant gap between the prevalence of child sexual abuse and disclosure underscores the need for new, innovative, and creative screening tools to identify victims to end the abuse and provide these victims with appropriate treatment. This article presents the cumulative efforts of a series of innovative studies dealing with sexually abused survivors and offenders that concentrates on preventing, assessing, screening, and treating Child Sexual Abuse (CSA).”
Lev-Wiesel R, Ramot O, Niv H, et. al.
Physical Versus Sexual Abuse as Reflected in Adolescents' Self-Figure Drawings: A Preliminary Study. J Child Sex Abus. 2022 Jan;31(1):33-50. PMID: 33416014
For 96 adolescents asked to draw themselves, significant differences were found for those who had experienced sexual abuse, physical abuse, or no abuse, especially features of the nose, hair, and lower body.
Laird L, Mulvihill N.
Assessing the Extent to Which Art Therapy Can Be Used with Victims of Childhood Sexual Abuse: A Thematic Analysis of Published Studies. J Child Sex Abus. 2022 Jan;31(1):105-126. PMID: 34126870
“This review considers the value of Art Therapy (AT) in recognizing individual needs and experiences and supporting victims to manage the lasting impact of abuse…AT particularly benefits rapport building between victim and therapist/investigator, and alleviates some psychological consequences of sexual abuse - particularly anxiety, post-traumatic stress, and dissociation…AT may also provide a communicative form, building a narrative where verbal communication is hindered.”
Prevention
Moon I, Han J.
Moderating Effects of Physical Activity on the Relationship between Adverse Childhood Experiences and Health-Related Quality of Life. Int J Environ Res Public Health. 2022 Jan 7;19(2):668. PMID: 35055490
From a survey of 127,370 adults from 17 states, “HRQOL [health-related quality of life] in adults is negatively associated with ACEs, but is positively associated with PA [physical activity]. We found buffering effects of PA in the following relationships: (1) child abuse and HRQOL, (2) child abuse and perceived physical health, (3) ACEs and perceived mental health, (4) child abuse and perceived mental health, and (5) household dysfunction and perceived mental health…improvement of PA level is a significant predictor of improved HRQOL of adults with ACEs.”
Hornor G.
Child Maltreatment Prevention: Essentials for the Pediatric Nurse Practitioner. J Pediatr Health Care. 2022 Mar-Apr;36(2):193-201. PMID: 34627666
General, comprehensive, practical review article.
Crowley DM, Connell CM, Noll J, Green L, Scott T, Giray C.
Legislating to Prevent Adverse Childhood Experiences: Growth and Opportunities for Evidence-Based Policymaking and Prevention. Prev Sci. 2022 Feb;23(2):181-191. PMID: 34599473
Authors conducted a comprehensive analysis of all state bills introduced over the past two decades to investigate the use and impact of ACE research, all related congressional office communications, and voting records “to understand the relationship between legislative members' public discussion of ACEs and their voting behavior on these bills. We find that legislators' public discourse is significantly related to ACE-related policymaking above and beyond political affiliation or demographic characteristics. Furthermore, key legislative language related to domestic violence, evidence-based practice, and prevention were significant predictors of whether an ACE-related bill becomes law-above and beyond the political party in power. These analyses highlight the ways in which ACE-related research has informed state policy. Based upon this work, we offer recommendations for researchers and policymakers.”
Quail KR, Ward CL.
Nonviolent Discipline Options for Caregivers and Teachers: A Systematic Overview of the Evidence. Trauma Violence Abuse. 2022 Apr;23(2):620-638. PMID: 33111651
“One reason for the persistence of corporal punishment may be the lack of awareness of positive disciplinary alternatives…A wide range of evidence-supported interventions exist, many of which have been found effective with severely challenging behavior…the use of these tools should be promoted not only for the prevention of violence but also for optimum child development.”
Vederhus JK, Haugland SH, Timko C.
A mediational analysis of adverse experiences in childhood and quality of life in adulthood. Int J Methods Psychiatr Res. 2022 Mar;31(1):e1904. PMID: 3498904
From a Norwegian representative survey of 28,047 adults asking about 3 specific ACEs: parents' problematic alcohol use (PPAU), parental separation/divorce, and lack of support from a trusted adult, “Of the examined ACEs, lack of support from a trusted adult had the strongest negative impact on adult QoL [quality of life]…The association between the ACEs and QoL was explained through the mediators of mental distress and social isolation…Adult support to vulnerable children could potentially ameliorate adult consequences of ACEs. In addition, adults reporting difficulties due to childhood adversities may benefit from therapeutic interventions that address both psychological distress and isolation.”
Clements-Nolle KD, Lensch T, Drake CS, Pearson JL.
Adverse childhood experiences and past 30-day cannabis use among middle and high school students: The protective influence of families and schools. Addict Behav. 2022 Feb 14;130:107280. PMID: 35279622
From a national survey of middle and high school students, there was a graded relationship between ACEs and past 30-day cannabis use (CU) for all students that was particularly strong among middle school students: 1 ACE (Adjusted Prevalence Ratio = 2.37), 2 ACEs (APR = 2.89), 3 ACEs (APR = 5.30), 4 + ACEs (APR = 7.86). Both family communication and school connectedness demonstrated a direct, independent protective relationship with past 30-day CU.
Researchers
SmithBattle L, Loman DG, Yoo JH, Cibulka N, Rariden C.
Evidence for Revising the Adverse Childhood Experiences Screening Tool: a Scoping Review. J Child Adolesc Trauma. 2021 May 6;15(1):89-103. PMID: 35222777
From a research review, authors analyzed current knowledge for expanding ACE categories and for revising the formatting and scoring the ACE screening tool. “Exposure to community violence (ECV) was the most frequently added category (15), followed by economic hardship in childhood (EHC) (13); bullying (10); absence/death of parent or significant others (9); and discrimination (7). This evidence supports the expansion of ACE screening tools.”
Lee N, Pigott TD, Watson A, et. al.
Childhood Polyvictimization and Associated Health Outcomes: A Systematic Scoping Review. Trauma Violence Abuse. 2022 Feb 26:15248380211073847. PMID: 35220817
In this research review, “There is a need to establish a valid polyvictimization construct that is consistently agreed upon in the research community. Findings summarize the specific health outcomes that can be targeted for further investigation and prevention efforts. Findings also suggest that the study of resilience and coping education for childhood polyvictims is sorely needed.”
Berman IS, McLaughlin KA, Tottenham N, et. al.
Measuring early life adversity: A dimensional approach. Dev Psychopathol. 2022 Mar 22:1-13. PMID: 35314009
“We review existing approaches to measuring two dimensions of adversity: threat and deprivation. We recommend specific measures for measuring these constructs…Developing new measurement tools…is an important goal for future research.”
Lee RD, D'Angelo DV, Dieke A, Burley K.
Recent Incarceration Exposure Among Parents of Live-Born Infants and Maternal and Child Health. Public Health Rep. 2022 Mar 18:333549221081808. PMID: 35301904
From a large multi-state study, the prevalence of incarceration exposure for a woman or her husband /partner shortly before or during pregnancy was 3.7%. Women with incarceration exposure had increased odds of hypertension, depressive symptoms, and infant admission to the ICU. “A parent's incarceration exposure is an adverse childhood experience with the potential to disrupt important developmental periods and have negative impacts on health outcomes of children.”
Brown M, Worrell C, Pariante CM.
Inflammation and early life stress: An updated review of childhood trauma and inflammatory markers in adulthood. Pharmacol Biochem Behav. 2021 Dec;211:173291. PMID: 34695507
This research review on inflammation as a consequence of childhood trauma showed multiple discrepancies arising from type of trauma, type of inflammatory marker, and additional variables. Researchers suggest more thorough reporting on sex differences, and also opening up this research to different types of maltreatment instead of being restricted to those typically measured.
Other of Interest
Russell JD, Heyn SA, Dean DC 3rd, Herringa RJ.
Pediatric PTSD is characterized by age- and sex-related abnormalities in structural connectivity. Neuropsychopharmacology. 2021 Nov;46(12):2217-2223. PMID: 34285368
Of 82 youth ages 8-18, of whom 39 met criteria for pediatric PTSD, in those with PTSD there was brain scan evidence of alteration of microstructure “suggesting an altered pattern of neurodevelopment that may contribute to persistence or worsening of illness. Broadly, our results suggest abnormal white matter development in pediatric PTSD, a finding which may contribute to illness persistence, comorbidity with other disorders, and poorer prognosis across time.”
Putnam-Hornstein E, Ahn E, Prindle J, et. al.
Cumulative Rates of Child Protection Involvement and Terminations of Parental Rights in a California Birth Cohort, 1999-2017. Am J Public Health. 2021 Jun;111(6):1157-1163. PMID: 33856882
Using linked data sources for 519,248 children born in California in 1999, “Overall, 26.3% of children were investigated for maltreatment, 10.5% were substantiated, 4.3% were placed in foster care, and 1.1% experienced a TPR [termination of parental rights]. Roughly 1 in 2 Black and Native American children were investigated during childhood. Children receiving public insurance experienced CPS involvement at more than twice the rate of children with private insurance…Conservatively, CPS investigates more than a quarter of children born in California for abuse or neglect. These data reinforce policy questions about the current scope and reach of our modern CPS.”
Thurston RC, Jakubowski KP, Wu M, et. al.
Sexual assault and white matter hyperintensities among midlife women. Brain Imaging Behav. 2021 Sep 23:10.1007/s11682-021-00536-2. PMID: 34553332
“White matter hyperintensities (WMHs) are markers of brain small vessel disease. WMHs can be detected decades before the onset of dementia and other disorders and can serve as early markers for these brain disorders…145 women (mean age = 59 years) without cardiovascular disease, stroke, or dementia were recruited…68% of women endorsed at least one of the traumas assessed…Women with trauma exposure had greater WMH volume than women without trauma. The single trauma most associated with WMH was [lifetime] sexual assault. Results persisted after adjusting for depressive or post-traumatic stress symptoms…Sexual assault may place women at risk for poor brain health.”
Vasan A, Mitchell HK, Fein JA, et. al.
Association of Neighborhood Gun Violence With Mental Health-Related Pediatric Emergency Department Utilization. JAMA Pediatr. 2021 Dec 1;175(12):1244-1251. PMID: 34542562
This cross-sectional study included 128,683 ED encounters for children aged 0 to 19 years living in 12 zip codes in Philadelphia, who presented to an urban academic pediatric ED 2014-2018. “After adjusting for age, sex, race and ethnicity, median household income, and insurance, children residing within one-eighth of a mile (2-3 blocks) of a shooting had greater odds of mental health-related ED presentations in the subsequent 14 days (adjusted odds ratio, 1.86), 30 days (aOR, 1.49), and 60 days (aOR, 1.35). Policies aimed at reducing children's exposure to neighborhood gun violence and mitigating the mental symptoms associated with gun violence exposure must be a public health priority.”
Guerra E, Westlake BG.
Detecting child sexual abuse images: Traits of child sexual exploitation hosting and displaying websites. Child Abuse Negl. 2021 Dec;122:105336. PMID: 34560400
Authors note use of file and folder naming patterns to improve automated detection of websites hosting and/or displaying child sexual abuse images (CSAI). “Websites specialize in either hosting or displaying CSAI with only 20% doing both. Neither hosting nor displaying websites fear repercussions. Over 27% of CSAI were displayed in the home directory (i.e., main page) with only 6% located in at least 4th-level sub-folder. Websites focused more on organizing images than hiding them.”
Case SM, Feldman CH, Guan H, et. al.
Post-Traumatic Stress Disorder (PTSD) and Risk of Systemic Lupus Erythematosus (SLE) among Medicaid Recipients. Arthritis Care Res (Hoboken). 2021 Jul 26:10.1002/acr.24758. PMID: 34309239
“In this large, racially and sociodemographic diverse US population study, we found that patients with prior PTSD diagnosis had twice the odds of a subsequent diagnosis of SLE [lupus].”
Test Rowse J, Mullane S, Bassed R, Tully J.
Technology-facilitated sexual assault in children and adolescents; is there a cause for concern? Fourteen years of experience at a metropolitan forensic paediatric medical service. J Paediatr Child Health. 2022 Mar;58(3):409-414. PMID: 34477277
From a medical record review of Australian children and adolescents who received a forensic examination for sexual assault, “Of 515 sexual assault cases between 2014 and 2020, 70 (14%) victims reported connecting with the offender on a technological platform, compared to 4% of cases between 2007 and 2013. In 2019 and 2020, TFSA [technology-facilitated sexual assault] comprised almost one-fifth of caseload. Of the 70 TFSA cases, the majority occurred at the first face-to-face meeting following a variable period of online communication. Approximately one-third of TFSA's occurred at the offender's residence, and another third in a public place (park, public toilets).”
Chandler CE, Austin AE, Shanahan ME. Association of Housing Stress With Child Maltreatment. Trauma Violence Abuse. 2022 Apr;23(2):639-659. PMID: 32677550
From a research review that included nine distinct measures of housing stress including homelessness or eviction, homeless or emergency shelter stays, foreclosure filing, housing instability, inadequate housing, physical housing risk, living doubled-up, housing unaffordability, and composite housing stress indicators, “housing stress is associated with an increased likelihood of caregiver or child self-reported maltreatment, child protective services (CPS) reports, investigated and substantiated CPS reports, out-of-home placements, and maltreatment death.”
Comments (0)