[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!! — Rafael Maravilla]
Child Abuse
Iob E, Lacey R, Giunchiglia V, Steptoe A.
Adverse childhood experiences and severity levels of inflammation and depression from childhood to young adulthood: a longitudinal cohort study. Mol Psychiatry. 2022 Apr;27(4):2255-2263. PMID: 35241782
While ACEs are associated with adult depression and inflammation, this ongoing national study looked at depression and inflammation at different stages of childhood. Most types of ACEs across all early-life periods were associated with elevated depression trajectories, while only bullying victimisation and sexual abuse in late childhood/adolescence were associated with inflammation. “These results suggest that ACEs are consistently associated with depression, whereas the associations of inflammation with ACEs and depression are weak in young people. Interventions targeting inflammation in this population might not offer protection against depression.”
Rodenbough A, Opolka C, Wang T, et. al.
Adverse Childhood Experiences and Patient-Reported Outcome Measures in Critically Ill Children. Front Pediatr. 2022 Jul 13;10:923118. PMID: 35911842
Of 84 children admitted to an academic pediatric ICU in Atlanta, Georgia, 54% had 1+ ACE, 29% 2+ ACEs and 10% 3+ ACEs. Those with 2+ ACEs scored as more anxious and with poorer family relationships. “Screening for ACEs may identify vulnerable children who would benefit from interventions and support.”
Ullmann H, Weeks JD, Madans JH.
Stressful Life Events Among Children Aged 5-17 Years by Disability Status: United States, 2019. NCHS Data Brief. 2022 Jan;(431):1-8. PMID: 35089855
This NCHS Data Report shows that children aged 5-17 years with disability were more likely than those without disability to be exposed to 4 stressful life events – community violence, parental or caregiver incarceration, or to be living with someone with significant mental illness/depression or drug or alcohol use.
Mechling BM.
Fostering better outcomes for youth of parents with opioid use disorder. J Child Adolesc Psychiatr Nurs. 2022 Aug;35(3):203-205. PMID: 35906827
Editorial review of the effects of parents with opioid use disorder on their children, including poverty, abuse, neglect, having a chaotic and unstable environment with multiple separations, witnessing domestic violence or parental overdose, parental incarceration, caregiving for siblings and parentification, and foster care placement with less likelihood of reunification. The author also notes multiple promising support programs both for parents and for children, with a need to increase awareness and availability of these programs.
Test Laskey A, Haney S, Northrop S, et. al.
Protecting Children From Sexual Abuse by Health Care Professionals and in the Health Care Setting. Pediatrics. 2022 Sep 1;150(3):e2022058879. PMID: 36032020
In this policy statement from the American Academy of Pediatrics, “Pediatricians and health care professionals should be trained to recognize and abide by appropriate provider-patient boundaries. Medical institutions should screen staff members for a history of child abuse issues, train them to respect and maintain appropriate boundaries, and establish policies and procedures to receive and investigate concerns about patient abuse.”
Negriff S, Huang BZ, Sharp AL, DiGangi M.
The impact of stay-at-home orders on the rate of emergency department child maltreatment diagnoses. Child Abuse Negl. 2022 Aug 6;132:105821. PMID: 35939889
Using data from the Kaiser system in California of children with at least one ED visit (407,228 total visits) between Jan 1, 2019 and Sep 30, 2021, in the month following California state pandemic lock-down, while the total number of ED visits significantly decreased, the rate of visits for child maltreatment doubled and then gradually returned to baseline. Increased risk was higher for children < 4 years old, female, Hispanic, and Black.
Yu JA, Bayer ND, Beach SR, Kuo DZ, Houtrow AJ.
A National Profile of Families and Caregivers of Children with Disabilities and/or Medical Complexity. Acad Pediatr. 2022 Aug 21:S1876-2859(22)00413-2. PMID: 36002069
From a large national survey, comparing children with no special needs, those with special healthcare needs (CSHCN), those with special healthcare needs and significant disabilities (CSHCN-SD), and those with medical complexity (CMC), the parents of CSHCN-SD and CMC were more likely to report feeling bothered by (adjusted odds ratio 5.0 and 6.3) and angry at their child (aOR 3.0 and 3.1); felt 40% less family resilience; were more likely to report 3+ ACEs for their child (aOR 3.3 and 3.7); were less likely to be able to cover basics (aOR 2.6 and 3.3); and more likely to report caregivers having to change jobs due to their child’s care (aOR 3.1 and 5.0). “Development and testing of interventions specifically targeting the well-being of CSHCN-SD and CMC families and caregivers is needed.”
Kang J.
Spanking and children's social competence: Evidence from a US kindergarten cohort study. Child Abuse Negl. 2022 Aug 1;132:105817. PMID: 35926250
From a national study, “Lifetime experience of spanking by age 5 was associated with higher externalizing behaviors [anger, aggression] at ages 6 and 7, and with lower self-control and interpersonal skills at age 6. These results remained significant after cases of frequent spanking were excluded.”
Winter SM, Dittrich K, Dörr P, et. al.
Immediate impact of child maltreatment on mental, developmental, and physical health trajectories. J Child Psychol Psychiatry. 2022 Sep;63(9):1027-1045. PMID: 35266137
Comparing 86 children aged 3-5 years with emotional or physical abuse or neglect to a control group of children without maltreatment over the following 2 years, maltreated children had increased psychiatric diagnoses; externalizing (anger, aggression) and internalizing (depression, anxiety) symptoms; impairments in cognitive, verbal, and motor development; and greater numbers of medical symptoms.
Pankowiak A, Woessner MN, Parent S, et. al.
Psychological, Physical, and Sexual Violence Against Children in Australian Community Sport: Frequency, Perpetrator, and Victim Characteristics. J Interpers Violence. 2022 Aug 9:8862605221114155. PMID: 35944902
From an online survey of 886 Australian adults from the general public, retrospectively reporting experiences of violence during childhood community sport, “82% of respondents experienced violence in sport as a child. Psychological violence was most prevalent (76%), followed by physical (66%) and sexual (38%) violence. Peers perpetrated the highest rates of psychological violence (69%), and the rates of physical and psychological violence by coaches (both >50%) were also high. Age, sexual orientation, disability, and hours of weekly sport participation as a child were all associated with childhood experience of violence in sport.”
Adult Manifestations of Child Abuse
Levy S, Muench J.
The epigenetic impact of adverse childhood experiences through the lens of personalized medicine. Epigenomics. 2022 Apr;14(8):425-429. PMID: 35220755
“We believe that information obtained through a combination of genetic family history and history of adverse childhood and resilient childhood experiences can lead to more precise risk assessment and therefore to more ’personalized’ treatment and care. We believe that over the next 5–10 years, the study of adverse childhood experiences and it’s relationship to both physical and mental health will be part of the standard curriculum for medical student and post-graduate medical education. This will include how knowledge of ACEs can enhance the health care provider–patient relationship in providing trauma-informed care. We also believe that the inclusion of resiliency along with ACEs will be routinely utilized in epigenetic research on the developmental origins of disease and in clinical trials for their treatments.
Malave L, van Dijk MT, Anacker C.
Early life adversity shapes neural circuit function during sensitive postnatal developmental periods. Transl Psychiatry. 2022 Aug 1;12(1):306. PMID: 35915071
Very detailed review article on early life adversity (ELA) and the effects of how ELA “alters the functional development of brain regions, neural circuits, and neurotransmitter systems that are crucial for cognition and affective [mood] behavior.” Authors also discuss the effects of genetics and epigenetics to determine individual differences in susceptibility and resilience to ELA, “to better treat or prevent psychiatric disorders that have their origin early in life.”
Ortiz R, Gilgoff R, Burke Harris N.
Adverse Childhood Experiences, Toxic Stress, and Trauma-Informed Neurology. JAMA Neurol. 2022 Jun 1;79(6):539-540. PMID: 35467693
“Neurologists stand poised to help patients understand the role that toxic stress physiology may play in the clinical presentation or severity of neurological condition(s)—and in effective treatment thereof…by incorporating interventions targeted at regulating stress physiology, and help reduce blame, shame, and stigmatization patients often feel in connection with early adversity and/or toxic stress symptomatology.
van Bentum JS, Sijbrandij M, Saueressig F, Huibers MJH.
The association between childhood maltreatment and suicidal intrusions: A cross-sectional study. J Trauma Stress. 2022 Aug;35(4):1273-1281. PMID: 35285097
For 149 Dutch outpatients receiving mental health treatment for suicidality, having involuntary and distressing thoughts about one's own suicide “suicidal intrusions”, a step towards suicidal actions, were significantly associated with childhood sexual abuse despite controlling for age, gender, PTSD diagnosis and depressive symptoms. “This finding implies that in the treatment of suicidal intrusions and suicidality, childhood sexual abuse should be identified and targeted with evidence-based treatments.”
Khan AN, Jaffee SR.
Alexithymia in individuals maltreated as children and adolescents: a meta-analysis. J Child Psychol Psychiatry. 2022 Sep;63(9):963-972. PMID: 35438190
In this research review, alexithymia, a deficit in the ability to recognize one’s own emotions (and in high levels of alexithymia the inability to recognize emotions in others), was associated in a graded manner with all forms of child maltreatment, especially for neglect, and especially for females.
Assini-Meytin LC, Fix RL, Green KM, Nair R, Letourneau EJ.
Adverse Childhood Experiences, Mental Health, and Risk Behaviors in Adulthood: Exploring Sex, Racial, and Ethnic Group Differences in a Nationally Representative Sample. J Child Adolesc Trauma. 2021 Nov 18;15(3):833-845. PMID: 35958728
For 9690 young adults followed over time, authors identified a graded association between ACEs and depression, suicide ideation, and current smoker status at both mean ages 21 and 38. Results were amplified for women and those of Native American descent.
Mahmood S, Li Y, Hynes M.
Adverse Childhood Experiences and Obesity: A One-to-One Correlation? Clin Child Psychol Psychiatry. 2022 Aug 12:13591045221119001. PMID: 35959544
From a survey of 119 adult patients seen at an academic weight management clinic, there was a positive relationship between ACE score and BMI (body mass index). “Our findings suggest ACE is not just related with the prevalence of obesity, but also the severity of obesity…as the ACE score increased by 1, the BMI increased by 1 unit as well.”
Jacquet-Smailovic M, Brennstuhl MJ, Tarquinio CL, et. al.
Relationship Between Cumulative Adverse Childhood Experiences and Myocardial Infarction in Adulthood: a Systematic Review and Meta-analysis. J Child Adolesc Trauma. 2021 Sep 22;15(3):701-714. PMID: 35958714
From this research review, cumulative ACEs were associated with an approximately 2 times increased risk of heart attack, after adjustment for heart disease risk factors and psychological factors.
Okwori G, Stewart S, Quinn M, Lawson D.
Health Care Burden and Expenditure Associated with Adverse Childhood Experiences in Tennessee and Virginia. J Child Adolesc Trauma. 2021 Aug 18;15(3):727-739. PMID: 35958731
The purpose of this article was “to estimate attributable burden and costs of conditions associated with exposure to Adverse Childhood Experiences (ACEs) in Tennessee (TN) and Virginia (VA) during 2017…Eight chronic diseases (asthma, obesity, hypertension, diabetes, chronic obstructive pulmonary disease (COPD), depression, cardiovascular disease, and arthritis) and two risk factors (smoking and drinking) associated with ACEs were analyzed in adults…The total costs associated with ACEs were about $15.5 billion ($3948) per person) and $20.2 billion ($6288 per person) in TN and VA, respectively. This study emphasizes the need to reduce ACEs due to high health and financial costs.”
Craner JR, Lake ES, Barr AC, Kirby KE, O'Neill M.
Childhood Adversity Among Adults With Chronic Pain: Prevalence and Association With Pain-related Outcomes. Clin J Pain. 2022 Sep 1;38(9):551-561. PMID: 35777964
Of 1794 adults presenting for treatment at a multidisciplinary pain management center, “Participants endorsing ≥4 ACEs had significantly worse pain-related outcomes and lower quality of life compared with individuals reporting fewer ACEs. Having ≥3 ACEs was associated with higher anxiety and depression levels. Experiences of childhood neglect negatively affected mental health-related outcomes independent of the number of ACEs.” There were no sex differences regarding outcomes.
Hemady CL, Speyer LG, Kwok J, et. al. Using network analysis to illuminate the intergenerational transmission of adversity. Eur J Psychotraumatol. 2022 Aug 18;13(2):2101347. PMID: 36016844
“By using network analysis, we were able to map out the web of relationships between ACEs, and found that when one ACE is present, other types of ACEs are likely to be present as well. Our network also demonstrated the complex interplay between ACEs, prenatal risk factors, and infant preterm birth and low birthweight. Physical abuse was the only childhood adversity linked directly to low birthweight.”
Kern A, Khoury B, Frederickson A, Langevin R.
The associations between childhood maltreatment and pregnancy complications: A systematic review and meta-analysis. J Psychosom Res. 2022 Sep;160:110985. PMID: 35816769
From a research review, maternal childhood maltreatment was associated with preterm birth (odds ratio = 1.27), low birth weight (OR = 1.42) and gestational diabetes (relative risk = 1.37); however authors found high levels of variability in data generation, and made suggestions for future research.
Gaietto K, Celedón JC.
Child maltreatment and asthma. Pediatr Pulmonol. 2022 Sep;57(9):1973-1981. PMID: 35583017
“In this article, we examine epidemiologic studies of child maltreatment and asthma and asthma-related outcomes, review the evidence for potential mechanisms underlying the child maltreatment-asthma association, and discuss future directions.”
Kletenik I, Holden SK, Sillau SH, et. al.
Gender disparity and abuse in functional movement disorders: a multi-center case-control study. J Neurol. 2022 Jun;269(6):3258-3263. PMID: 35098346
Functional movement disorders (FMD), frequently cared for in neurology clinics, involve abnormal movements such as tremor, muscle contraction or abnormal postures, and muscle weakness. Historically, FMD was called “conversion disorder”, and considered a psychological disorder caused by the conversion of emotional processes into symptoms. Using self-reported trauma data from 696 patients with FMD from 6 clinic sites, 35.3% of women and 11.5% of men reported a lifetime history of sexual abuse with controls reporting 10.6% and 5.6%. 36.5% of women and 27.8% of men with FMD reported lifetime physical abuse with controls reporting 17.0% and 19.4%. Among women, a history of sexual abuse increased the odds of FMD by a factor of 4.57 and physical abuse by a factor 2.80, while a history of both sexual and physical abuse increased the odds of FMD by 7.99 compared to other neurologic disease controls.
Bristow LA, Afifi TO, Salmon S, Katz LY.
Risky Gambling Behaviors: Associations with Mental Health and a History of Adverse Childhood Experiences (ACEs). J Gambl Stud. 2022 Sep;38(3):699-716. PMID: 34164766
Of 1000 adult parents, mean age 45.2 years, 86.5% female, “Except for emotional neglect and household mental illness, all other ACEs significantly increased the likelihood of being an at-risk/problem gambler (when compared to non-gambler)…three of the five new ACEs (i.e., spanking, parental gambling, and poverty) remained significant after adjusting for sociodemographic factors and they were among the highest odds ratios for an increased likelihood of at-risk/problem gambling.”
Kong J, Easton SD, Zhang Y.
Sexual and Marital Satisfaction in Older Adulthood: Effects of Childhood and Adulthood Violence Exposure. Gerontologist. 2022 Aug 17:gnac126. PMID: 35976151
Of 5,391 Wisconsin adults in their early 70s, “Childhood sexual abuse was directly associated with lower levels of sexual and marital satisfaction in late adulthood. Other ACEs were associated with currently not being married and greater numbers of marriages. Furthermore, other ACEs were significantly associated with low levels of marital satisfaction through IPV victimization.”
Lüönd AM, Wolfensberger L, Wingenbach TSH, et. al.
Don't get too close to me: depressed and non-depressed survivors of child maltreatment prefer larger comfortable interpersonal distances towards strangers. Eur J Psychotraumatol. 2022 May 30;13(1):2066457. PMID: 35957629
Using the stop-distance method (i.e. a team member approached participants until the latter indicated discomfort), authors assessed CIPD (comfortable interpersonal distance) in 84 adults with a self-reported history of childhood maltreatment (CM) with and without depressive symptoms, and 57 adult controls without a history of CM or depressive symptoms. CIPD results were 68 cm (26.8 in) for controls; 86 cm (33.9 in) for all adults with CM, depressed and non-depressed; and 145 cm (57.1 in) for adults with CM and depression. For adults with CM and without depression, only emotional abuse showed increased CIPD over controls.
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