[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]
Adolescents
Gaylor EM, Krause KH, Welder LE, et al.
Suicidal Thoughts and Behaviors Among High School Students - Youth Risk Behavior Survey, United States, 2021. MMWR Suppl. 2023 Apr 28;72(1):45-54. PMID: 37104546
Using data from a national survey, “from 2019 to 2021, female students had an increased prevalence of seriously considered attempting suicide (from 24.1% to 30%), an increase in making a suicide plan (from 19.9% to 23.6%), and an increase in suicide attempts (from 11.0% to 13.3)…Prevalence of suicidal thoughts and behaviors remained stable overall for male students from 2019 to 2021.”
Meadows AL, Strickland JC, Hyder SM, et al.
Adverse childhood experiences and early initiation of substance use: A survival analysis. Int J Psychiatry Med. 2023:912174231195751. PMID: 37594029
From a study of 107 adults, “A significant association was found between higher ACE scores and earlier initiation of cigarette and non-medical prescription opioid use…Primary prevention of ACEs, screening, and intervention in childhood may be unique approaches to decrease the risk of substance use and substance use disorder.”
Schiff M, Auslander WF, Gerke DR.
Child Maltreatment, Mental Health, and Self-Reported Health Among Adolescent Girls in Child Welfare. Journal of child & adolescent trauma. 2023;16(3):759-71. PMID: 37593056
Of 249 girls aged 12-19 years in the child welfare system, “Higher levels of emotional, physical, and sexual abuse, and physical neglect were significantly associated with poorer ratings of health. PTSD and depression were significant mediators between histories of childhood emotional, physical, and sexual abuse and physical health…Trauma focused interventions to reduce symptoms of PTSD and depression among this vulnerable group of adolescents are essential to improve health.”
Kamke K, Mullin TM, Goodman KL.
Barriers to Seeking Medical Care Among Youth Victims of Sexual Violence. J Adolesc Health. 2023 Sep 5:S1054-139X(23)00345-2. PMID: 37676193
Using data from 520 young victims who contacted the National Sexual Assault Online Hotline with physical health concerns and who had not received medical care, “Victims' barriers were rooted in individual beliefs and contextual realities reflected in three categories: (1) perception that medical care was not needed, (2) anticipated consequences of seeking medical care, and (3) inability to physically access medical care. Victims who perceived care as unnecessary did not understand the health implications of abuse or minimized their need for care. Anticipated consequences included privacy and control over disclosure, stigmatization, retaliation from the perpetrator, family disruptions, and retraumatizing medical treatment. Victims unable to physically access care were uncertain how to access care independently, lacked social support, or were prevented from care by the perpetrator.”
Ball B, Hoefer S, Ding X, Sevillano L, Faulkner M.
Promoting Healthy Relationships in Foster Care-"If I Had Seen What a Healthy Relationship Looks Like, that Would Have Changed My Perspective". Violence Against Women. 2023:10778012231199106. PMID: 37674405
From interviews with 27 young adults, “From the perspective of the youth, foster care modelled controlling or disconnected relationships, and did not provide them with working models for healthy relationships…Restrictive placement rules, meant to promote safety, did not allow for normal social activities and development. Furthermore, youth responded to the controlling environment either with silent conformity or rebellion, such as running away and abrupt exit from foster care, which increased risk for IPV as youth experienced instability and homelessness and some engaged in survival sex. Particularly striking was the widespread absence of conversations with caregivers about dating and sexuality…Our study also highlighted fragile connections with peers…A majority of participants in this study perceived themselves as missing social skills or experienced anxiety around people their own age.” Authors make recommendations.
Van der Watt ASJ, Kidd M, Roos A, Lesch E, Seedat S.
Romantic relationship dissolutions are significantly associated with posttraumatic stress symptoms as compared to a DSM-5 Criterion A event: a case-case-control comparison. European journal of psychotraumatology. 2023;14(2): 2238585. PMID: 37526098
“Non-marital romantic relationship dissolutions are common among emerging adult students and may result in severe distress and suicidality.” In a survey of 2,022 university students, comparing a group with a romantic relationship dissolution vs. a DSM recognized trauma experience vs. a control group with a stressful life event, both the romantic breakup group and the trauma group significantly scored positive for probable PTSD, with the romantic group having a higher percentage of post-traumatic stress symptoms than the trauma group (72.9% vs. 55.4%).
Domestic Violence – Effects on Children
Orr C, Kelty E, Fisher C, O'Donnell M, Glauert R, Preen DB.
The lasting impact of family and domestic violence on neonatal health outcomes. Birth. 2023 Sep;50(3):578-586. PMID: 36190166
Of 1230 Australian women who gave birth within 12 months of experiencing family and domestic violence (antenatal = AFDV), compared to groups with a past history (HFDV) and no history of (NFDV), women in the AFDV group had higher proportions of factors associated with poor neonatal outcomes including smoking (42.4%), substance use (23.0%), and mental health disorders (34.8%). Neonates born to AFDV mothers had significantly higher odds of congenital anomalies (OR: 1.51), low birth weight (1.74), and preterm birth (1.48) compared with neonates born to no FDV mothers.
Khatlani K, Azam I, Baqir M, Mehmood A, Pasha-Razzak O.
Exploring the relationship between intimate partner violence during pregnancy and stillbirths. Injury. 2023 Aug;54 Suppl 4(Suppl 4):110477. PMID: 37573063
Comparing 256 Pakistani women aged 25-34 who experienced a stillbirth to matched controls, the women with stillbirth were 4 times more likely to report physical IPV during pregnancy.
Janczewski C, Mersky J, Plummer Lee C.
Intergenerational transmission of child protective services involvement: Exploring the role of ACEs and domestic violence among families who receive home visiting services. Child Abuse Negl. 2023;144:106384. PMID: 37542996
From a sample of 3039 Wisconsin caregivers who received home visiting programs, 22.8% were also involved with CPS. CPS prevalence rates were associated separately with caregiver personal ACEs as well as DV in the home.
Lévesque S, Rousseau C, Jean-Thorn A, et al.
Reproductive Coercion by Intimate Partners: Prevalence and Correlates in Canadian Individuals with the Capacity to be Pregnant. PLoS One. 2023;18(8):e0283240. PMID: 37535635
From a survey of 427 Canadian adults aged 18-55 years, 92% women, “63.9% of participants reported at least one lifetime experience of RC [reproductive coercion]…contraceptive sabotage was the most common form (62.8%). Of the participants who had been pregnant, 9.8% reported control of pregnancy outcomes…low education level and IPV increased the risk for control of pregnancy outcomes…These findings underscore the importance of RC in the lives of many Canadian individuals.”
Thomas SA, Clements-Nolle KD, Wagner KD, et al.
Adverse childhood experiences, antenatal stressful life events, and marijuana use during pregnancy: A population-based study. Prev Med. 2023;174:107656. PMID: 37543311
Of 2483 pregnant women in Nevada, 9.8% used marijuana during the most recent pregnancy. Risk factors for marijuana use included 1+ ACE (adjusted prevalence ratio 1.96), 3+ ACE (3.58), 4+ ACE (3.67), and 4+ antenatal stressful life events (ASLE) (3.12). “There was evidence of interaction for high ACE and ASLE exposure on an additive scale…Screening for ACEs and ASLEs during pregnancy, referrals to appropriate behavioral health services, and trauma-informed approaches are important to address marijuana use during pregnancy.”
Sexual Assault
Goodman KL, Kamke K, Mullin TM.
Online Help-Seeking Among Youth Victims of Sexual Violence Before and During COVID-19 (2016-2021): Analysis of Hotline Use Trends. JMIR public health and surveillance. 2023;9:e44760. PMID: 37566446
Using data from the National Sexual Assault Online Hotline (NSAOH), “Most youth victims [<18 years] were abused by family members prior to (1013/1677, 60.4%) and after (2658/3661, 72.6%) the onset of COVID-19. The number of youth victims contacting NSAOH spiked in March 2020 and peaked in November 2020 for all youth discussing recent events. We observed a decline in youth victims into spring 2021 for all youth. Trends were stable for adults discussing recent events.”
Human Trafficking
Hornor G, Hollar J, Landers T, Sherfield J.
Healthcare Use and Case Characteristics of Commercial Sexual Exploitation of Children: Teen Victims Versus High-Risk Teens. J Forensic Nurs. 2023 Jul-Sep 01;19(3):160-169. PMID: 37590938
In a chart review from a midwestern academic ED and child advocacy center, high risk factors for commercial sexual exploitation of children included homelessness or life on the streets; runaway behavior; living with mother only; placement in a juvenile detention center, residential treatment center or group home; number of living arrangements (4+); legal age-inappropriate sex; and sexually transmitted infections.
Hodgins E, Mutis J, Mason R, Du Mont J.
Sex Trafficking of Women and Girls in Canada: A Scoping Review of the Scholarly Literature. Trauma Violence Abuse. 2023;24(4):2363-78. PMID: 35596558
“Key findings highlighted challenges in conceptualizing sex trafficking centered largely around issues of coercion and consent. Pathways into trafficking (economic displacement, past abuse, and broken ties with family and community) and gaps and barriers in anti-trafficking responses (narrow or conflicting definitions, stigmatization and criminalization of sex work, and a lack of accessible or appropriate services) particularly impacted Indigenous, im/migrant, and other marginalized women and girls. There is a paucity of empirical studies on sex trafficking in Canada and this has implications for the development of data-driven policies and protocols.”
LGBTQ Concerns
Chen M.
"Are You-?" "Are You?" Queer Advocacy at Contemporary Neoliberal Rape Crisis Centers. Violence Against Women. 2023:10778012231192606. PMID: 37545388
“This article draws on semistructured interviews with 23 LGBTQ+ advocates to explore how they navigate their sexual, gender, and racial identities at rape crisis centers today. Results show that LGBTQ+ advocates choose the ways that their sexual and gender identities are visible or invisible at their agency, usually to improve LGBTQ+ survivor services.”
Race/Cultural Concerns
Rattan J, Bartlett TR.
Potential influence of nurses' implicit racial bias on maternal mortality. Public Health Nurs. 2023 Sep-Oct;40(5):773-781. PMID: 37141152
“An increasing body of research describes the phenomenon of implicit racial bias among providers and how it may affect communication, treatment decisions, the patient care experience, and health outcomes. This synthesis of literature reviews and distills current research on the presence and influence of implicit racial bias among nurses…and interventions that can mitigate its effects.”
Goldstein E, Brown RL.
Influence of Maternal Adverse Childhood Experiences on Birth Outcomes in American Indian and non-Hispanic White Women. MCN Am J Matern Child Nurs. 2023 Sep-Oct 01;48(5):258-265. PMID: 37326514
Of 2,343 South Dakota pregnant women, “American Indian versus non-Hispanic White women had a higher mean ACE score (3.37 vs. 1.64). Adjusting for proportional differences, members of both groups with ACEs demonstrated significantly increased odds of prenatal and postpartum depression, preterm birth and low birthweight.
Hadley M, Oppong AY, Coleman J, Powell AM.
Structural Racism and Adverse Pregnancy Outcomes Through the Lens of the Maternal Microbiome. Obstet Gynecol. 2023 Oct 1;142(4):911-919. PMID: 37678901
“Emerging data from studies that investigate the intestinal microbiome in pregnancy suggest strong influence of a poor diet on adverse pregnancy outcomes…We review evidence that links systemic racism to pregnancy health outcome differences with a focus on the vaginal and intestinal microbiomes as well as diet. We also review how structural racism ultimately contributes to inequitable access to healthy food and higher risk environmental exposures among pregnant people of lower socioeconomic status and exacerbates common pregnancy comorbidities.”
Karvonen KA, Balay-Dustrude E, Do A, et al.
Race, ethnicity, and experienced racism are associated with adverse physical and mental health outcomes among cancer survivors. Cancer. 2023 Oct 1;129(19):3023-3033. PMID: 37394987
“Data from 48,200 cancer survivors between 2014 and 2020 were evaluated…All historically marginalized racial/ethnic groups were more likely to experience at least one adverse health outcome compared with non-Hispanic White survivors.” Those who physically experienced racism were 2.1 times as likely to report poor physical health, report poor mental health (3.51), inadequate sleep (2.14), depression (2.33), and activity limitations (1.42) compared with those who had not experienced racism. Similar associations were observed for emotionally experienced racism.
Rides At The Door M, Shaw S.
The Other Side of the ACEs Pyramid: A Healing Framework for Indigenous Communities. Int J Environ Res Public Health. 2023 Feb 25;20(5):4108. PMID: 36901119
“We provide a holistic Indigenous Wellness Pyramid …to guide pathways toward healing in Indigenous communities.”
Armstrong-Mensah E, Rasheed N, Williams D, et al.
Implicit Racial Bias, Health Care Provider Attitudes, and Perceptions of Health Care Quality Among African American College Students in Georgia, USA. Journal of racial and ethnic health disparities. 2023;10(5): 2600-12. PMID: 36331715
From a survey of 63 African American school of public health students in Georgia, “Provider brushes off patient concerns when providing medical care (29.9%), stereotyping (26.9%), and the lack of communication during medical care (25.4%) were the three main implicit racial attitudes identified by GSU SPH students. Owing to the poor quality of care they receive from their health care providers, some students (28.4%) are reluctant to utilize health care services, distrust doctors that are not from their race (34.3%), do not adhere to treatment (19.4%), and prefer to use home remedies (28.4%) when ill. Students recommended cultural competency training, holding health care providers accountable for their actions, and increasing African American health care providers in Georgia as ways to address health care provider attitudes and quality of care.”
Griffith DM, Towfighi A, Manson SM, et al.
Determinants of Inequities in Neurologic Disease, Health, and Well-being: The NINDS Social Determinants of Health Framework. Neurology. 2023;101(7 Supplement 1):S75-s81. PMID: 37580154
“We offer this framework to…illustrate how behavioral and biological factors occur in a social and economic context, factors that have been understudied as points of intervention to reduce inequities in neurologic disease.”
Mehta LS, Velarde GP, Lewey J, et al.
Cardiovascular Disease Risk Factors in Women: The Impact of Race and Ethnicity: A Scientific Statement From the American Heart Association. Circulation. 2023 May 9;147(19):1471-1487. PMID: 37035919
“Language barriers, discrimination, acculturation, and health care access disproportionately affect women of underrepresented races and ethnicities. These factors result in a higher prevalence of cardiovascular disease and significant challenges in the diagnosis and treatment of cardiovascular conditions…This scientific statement reviews the current evidence on racial and ethnic differences in cardiovascular risk factors and current cardiovascular preventive therapies for women in the United States.”
Briggs E, Hanson R, Klika JB, et al.
Addressing Systemic Racism in the American Professional Society on the Abuse of Children Publications. Child Maltreat. 2023:10775595231191394. PMID: 37554071
“In this commentary, the authors detail concrete steps over the coming years that will advance diversity, equity, inclusion and justice through American Professional Society on the Abuse of Children's (APSACs) flagship journal, Child Maltreatment.”
Goel N, Hernandez A, Thompson C, et al.
Neighborhood Disadvantage and Breast Cancer-Specific Survival. JAMA Netw Open. 2023 Apr 3;6(4):e238908. PMID: 37083666
“A total of 5027 women with breast cancer were included: 55.8% were Hispanic, 17.5% were non-Hispanic Black, and 27.0% were non-Hispanic White. Mean age was 55.5 years. Women living in the most disadvantaged neighborhoods had shorter breast cancer-specific survival compared with those living in the most advantaged neighborhoods after controlling for individual-level sociodemographic, comorbidity, breast cancer risk factor, access to care, tumor, and National Comprehensive Cancer Network guideline-concordant treatment characteristics (hazard ratio, 1.29).
Hill-Briggs F, Fitzpatrick SL.
Overview of Social Determinants of Health in the Development of Diabetes. Diabetes care. 2023;46(9):1590-8. PMID: 37354331
“The incorporation of socioeconomic and political systems and racism as root causes and current drivers of adverse SDOH into U.S. SDOH frameworks enables an emphasis shift from primary individual- and neighborhood-level time-limited solutions to multisector and all-of-government initiatives that bring requisite policy change and permanent structural change.”
Perpetrators
Kaufman-Parks AM, Longmore MA, Manning WD, et al.
Understanding the effect of adverse childhood experiences on the risk of engaging in physical violence toward an intimate partner: The influence of relationship, social psychological, and sociodemographic contextual risk factors. Child Abuse Negl. 2023;144:106381. PMID: 37542994
Of 878 emerging adults, “ACEs had a cumulative effect on IPV, where each additional ACE increased the odds of engaging in IPV by 51.0 %. However, current drug use (OR = 1.131), arguments between partners (OR = 1.517), partner mistrust (OR = 1.663), and jealousy and control (OR = 1.412) were also significant correlates of IPV reports…individuals working with clients who engage in IPV would do well to address the long-term trauma impacts of early life adversity in addition to more proximal risk factors to reduce the risk of continued violence.”
Steely Smith M.
"I'm Not a Child Molester, But a Victim Myself": Examining Rationalizations Among Male Sex Offenders Who Report Histories of Childhood Sexual Abuse. Int J Offender Ther Comp Criminol. 2023;67(12):1254-71. PMID: 35670571
“Persons convicted of sexual offenses hold distorted attitudes and beliefs, or rationalizations that minimize the severity of their offending.” This study looked at the differences in distortions of male sex offenders who themselves had experienced child sexual abuse and those who had not.
Bennett A, Jackson Y, Gabrielli J.
A social network analysis of perpetrators of child maltreatment reported by youth in foster care. Child Abuse Negl. 2023;145:106432. PMID: 37683404
Using data from 503 youth in foster care (8-21 years old), “Biological parents and peers were the most common perpetrators of physical and psychological abuse with peers and non-family adults being most common for sexual abuse.”
Swaby H, Lievesley R.
"Falling Through the Cracks": A Retrospective Exploration of the Barriers to Help-Seeking Among Men Convicted of Sexual Crimes. Sex Abuse. 2023;35(7):812-41. PMID: 36537848
“This research has explored the emotional experience of living with offense-related sexual thoughts. It has illuminated the narrative accounts of individuals who suffered immensely with their attractions before going on to offend, offering insight into how, and with more support services available, their actions could have been prevented.”
Comments (0)