Relevance of ACE Scores in Teens with Depression and Anxiety: A Maui Pilot Study.

In the aftermath of the Covid pandemic and the notable rise of teen depression and anxiety (DA), there is an urgent need to focus on youth mental health. Another important variable to consider is the presence of adverse childhood experiences (ACE), which can be associated with chronic mental and physical health conditions. This pilot study explores how ACEs relate to DA for adolescents in Maui, Hawai'i. The cohort was 75 patients seen at a Kaiser Pediatric Clinic in the spring of 2022. Data was collected from standard questionnaires and the Pediatric ACEs and Life-Events Screener (PEARLS). There were significant associations between DA and a high ACE score (4+), as well as female sex. A high ACE score can alert providers to initiate a trauma informed dialogue with patients. The effects of trauma are not often discussed at routine visits. Mental health care needs and community support can also be addressed as needed. The PEARLS questionnaire is a standard tool to help clinicians be more trauma-informed. This study explores its relevance at routine adolescent visits.

Adverse childhood experiences and profiles of healthy orthorexia versus orthorexia nervosa: towards an explanatory model of orthorexia as a multidimensional eating style.

BACKGROUND: Orthorexia is a complex phenomenon comprising distinct dimensions, including orthorexia nervosa (ON) and healthy orthorexia (HO). However, little is known about the factors influencing these dimensions, their disparities, and the psychological factors underlying orthorexia behaviours. OBJECTIVES: This study aims to explore ON versus HO dimensions and the predictive role of adverse childhood experiences (ACEs) in a nationally representative sample of Polish individuals. In addition, we aim to investigate the mediating roles of alexithymia, embodiment, and experiential avoidance levels in this association. METHODS: A representative sample of Polish adults (n = 3557) participated in this study. Dimensions of orthorexia (HO, ON) were assessed using the Teruel Orthorexia Scale, while ACEs were evaluated using the Adverse Childhood Experiences Questionnaire. Levels of alexithymia were measured using the Toronto Alexithymia Scale, experiential avoidance through the Acceptance and Action Questionnaire, and embodiment intensity via the Experience of Embodiment Scale. RESULTS: Cluster analysis identified two distinctive orthorexia profiles in the whole sample, i.e., HO (n = 469) and ON (n = 1217), alongside three intermediate HO/ON profiles (n = 1871). The number of ACEs predicted ON tendencies as opposed to HO behaviours in participants. The mediating role of alexithymia, experiential avoidance, and embodiment in the association between ACEs and ON was also observed. CONCLUSIONS: Our study suggests that orthorexia is a multidimensional eating style shaped by socio-cultural factors. Adverse childhood experiences may be related to ON behaviours by mediating psychological factors such as experiential avoidance, alexithymia, and embodiment. Effective education and collaborative support are necessary for addressing ON tendencies.

Types and timing of trauma exposure across the life course and maternal hypertension.

BACKGROUND: Exposure to trauma across the life course may be associated with cardio-metabolic dysfunction during pregnancy; however, previous research has been inconsistent, particularly in highly exposed populations. OBJECTIVES: To estimate associations between types and timing (first occurrence) of trauma exposure and hypertension experienced during pregnancy in a safety-net hospital in Atlanta, Georgia, 2011-2022. METHODS: Participants completed a 14-item trauma screener. We linked that information to data from the medical record on hypertension (including chronic hypertension, gestational hypertension or preeclampsia). We fit logistic regression models and used the estimates to calculate risk ratios for each trauma type and each critical window (0-9 years, 10-19 and 20+). We fit unadjusted models and adjusted for age, parity and education. RESULTS: We included 704 individuals with a delivery within 12 months following screening. The majority (94%, 661) reported at least one traumatic event, most commonly witnessing violence (79.4%). Overall, 18% experienced gestational hypertension, 10.8% chronic hypertension and 11.9% preeclampsia. Among individuals who reported trauma, 31.5% screened positive for probable posttraumatic stress disorder and 30.9% for probable depression, compared to 0 and 2.3% among those without reported trauma. No trauma type (violence, witnessing violence, non-interpersonal or sexual assault) was associated with increased hypertensive risk, regardless of timing. CONCLUSIONS: In this sample with a high trauma and hypertension burden, trauma was not associated with an elevated risk of hypertension during pregnancy, despite a high burden of PTSD and depressive symptoms among people with trauma exposure.

Adolescents' Adverse Childhood Experiences, Poor Mental Health, and Substance Use During the COVID-19 Pandemic.

PURPOSE: Adverse childhood experiences (ACEs) increase the risk for poor mental health (MH) and substance use. We describe relationships between adolescents' ACEs, substance use, and poor MH occurring during the COVID-19 pandemic. METHODS: We conducted a secondary analysis of data among U.S. high school students aged <18 years, who participated in the nationally representative Adolescent Behaviors and Experiences Survey. Data were collected from January to June 2021. Bivariate and multivariable analyses assessed associations between individual ACEs (physical, emotional abuse by parent or caregiver, parent or caregiver job loss, food insecurity, sexual violence, physical dating violence, or cyber bullying) and cumulative ACEs (0, 1-2, 3, 4+) experienced during the pandemic and substance use; stratified analyses assessed effects of poor MH on associations between ACEs and substance use. RESULTS: Use of all substances was higher among adolescents with ACEs, particularly those who experienced both ACEs and poor MH during the COVID-19 pandemic. Prevalence of substance use was especially high among adolescents exposed to any sexual violence or physical dating violence. Compared to adolescents without ACEs, a higher percentage of adolescents with 4+ ACEs reported current use of alcohol (adjusted prevalence ratio [aPR], 5.32) or marijuana (aPR, 5.86), misuse of prescription pain medications (aPR, 8.82), binge drinking (aPR, 7.70), and increased alcohol (aPR, 6.54) or drug (aPR, 7.09) use during the pandemic. DISCUSSION: The individual and combined impact of ACEs and MH on adolescent substance use reinforce the need for trauma-informed care and primary prevention of ACEs to prevent and mitigate poor MH and substance use among adolescents.

Adverse Childhood Experiences, Perceived Discrimination, and Mental Health in Sexual and Gender Minoritized Adults: Comparing Stress Accumulation and Stress Sensitization Models.

Purpose: The purpose of this study was to assess the relationship between adverse childhood experiences (ACEs) exposure, perceived discrimination, and anxiety and depressive symptoms in sexual and gender minoritized (SGM) adults in the United States. Methods: Respondents (n = 4445) from a national Qualtrics research panel completed a web-based survey. Guided by the stress proliferation (mediation model) and stress sensitization (moderation model) models, we examined the relationships between ACEs and perceived discrimination and the severity of anxiety and depressive symptoms in adulthood. Results: Cumulative ACEs exposure was positively associated with everyday discrimination scale (EDS) scores. ACEs and EDS scores had a significant direct association with anxiety and depressive symptoms. We found support for EDS as a mediator for anxiety (ß = 0.12, p < 0.001) and depressive symptoms (ß = 0.14, p < 0.001) and for ACEs as a moderator of the relationship between EDS and anxiety (ß = -0.04, p = 0.004) and depressive (ß = -0.05, p = 0.001) symptoms. Conclusions: These findings suggest that both stress proliferation and stress sensitization likely contribute to disparities in anxiety and depressive symptoms in SGM adults. This finding supports the integration of social safety and minority stress perspectives regarding health disparities in SGM populations. Exposure to early life adversity likely alters neurodevelopment, which in turn increases awareness of the lack of social safety in adulthood, reduces capacity to cope with minority stress exposure, and ultimately contributes to increased anxiety and depressive symptoms. Prevention efforts should focus on building positive and compensatory childhood experiences.

Effects of adverse childhood experiences on observed parenting and children's behavior problems among Jewish and Arab Muslim families in Israel.

Research points to the substantial impact of parents' exposure to adverse childhood experiences (ACEs) on parents and their children. However, most studies have been conducted in North America, and research on ACEs effects on observed parenting or on intergenerational transmission of ACE effects is limited. We therefore studied families from diverse ethnocultural backgrounds in Israel and examined whether mothers' ACEs hampered maternal sensitivity and the quality of the home environment and whether mothers' psychological distress mediated these links. We also explored whether mothers' ACEs predicted children's behavior problems indirectly through maternal psychological distress and whether maternal sensitivity and the home environment attenuated this mediating path. Participants were 232 mothers (Mchild age = 18.40 months, SD = 1.76; 63.36% non-ultra-Orthodox Jewish, 17.24% ultra-Orthodox Jewish, 19.40% Arab Muslim). Results showed mothers' ACEs were directly associated with decreased maternal sensitivity. Mothers' ACEs were indirectly associated with more behavior problems in children through mothers' higher psychological distress, and maternal sensitivity moderated this indirect link; it was significant only for mothers who showed lower sensitivity. Findings emphasize the significant role ACEs play in early mother-child relationships. The importance of including ACE assessment in research and practice with families of infants and toddlers is discussed.

Adverse childhood experiences, education, and involvement in terrorist violence: Examining mediation and moderation.

Most perpetrators of terrorist violence have had some level of post-secondary school education, with many enrolled in education at the time of their attacks. Exploring this premise in the context of prevention, this article draws from data gathered on a purposive sample (N = 206) of radicalized individuals from Europe and North America, half of whom became involved in terrorist violence at the end of their radicalization trajectories. Through a lens of educational participation, we propose novel, non-linear frameworks for understanding radicalization outcomes. To do so, two factors are explored that uniquely intersect when an individual enters a school setting: Adverse childhood experiences (ACE) and the human capital provided by education. As hypothesized, exposure to ACE was found to be associated with radicalization trajectories culminating in terrorist violence at the bivariate level (OR = 2.08). Consistent with the developmental-assets framework, it was further hypothesized that this relationship would be mediated by enrollment in education; however, results did not support this hypothesis. Instead, consistent with resiliency-based models, it was found that the relationship between ACE and involvement in terrorist violence was significant for those who abandoned education during radicalization (OR = 2.07). As well as contributing to theoretical models of radicalization to terrorist violence, identifying the furtherance of education as a moderator of risk may signal an important preventative strategy for violent extremism. Keeping enrolled students engaged in their programs, even if only nominally, may also forego the need for educators to engage in potentially controversial practices such as alerting the authorities to students who display signs of radicalization.

Pilot study of parental alienation items in the adverse childhood experiences scale.

BACKGROUND: Adverse Childhood Experiences (ACEs) and Parental Alienation (PA)are forms of adverse events negatively affecting children globally. The current study was to identify a revised ACEs measure that includes a screening item for PA. METHODS: A total of 231 undergraduate students, ages 18 to 37, were surveyed for this analysis. A factor analyses was performed to identify what PA item, out of four, would correlate most strongly with existing ACEs scale items. Convergent and divergent validity was assessed. An exploratory factory analyses was conducted to identify factor structure of scale items and a confirmatory factory analysis of extracted factors was used to assess model fit. RESULTS: Over half (60 %) of the sampled population reported at least one ACEs item. All four PA items were significantly correlated with converging constructs (r = 0.68, p < .01). Out of four PA items, one PA item significantly outperformed the other three items in relation to convergent validity and was used to create a new ACEs-PA scale item (r = 0.33, p < .01). A two factor solution was identified with the new PA item loading, accounting for 35 % of the variance, explaining more variance in both outcomes (R2 = 0.43 and R2 = 0.16) than the original ACEs scale when comparing the adjusted R2 values (R2 = 0.35 and R2 = 0.13). Limitations This study used participant self-reporting methods subjecting it to retrospective bias. CONCLUSION: Within the population, the new PA item factored significantly with existing ACEs, suggesting the capture of an additional adverse childhood experience.

Integrating the Attachment, Regulation, and Competency Trauma-Informed Framework in Inpatient, Day Treatment, Partial Hospitalization,and Residential Treatment Settings.

Pediatric mental health needs are currently on the rise across all levels of care. The COVID-19 pandemic accentuated concerns within our mental health system, not only for those requiring care, but also for care providers. One particular area of concern is access to care for those that require acute care or crisis stabilization (eg, emergency department visits or stays on crisis stabilization units). The Attachment, Regulation, and Competency (ARC) approach, a flexible trauma-informed treatment framework, provides equitable and effective treatments for youth as well as systems to support health care professionals caring for these youth. Trauma-informed care, particularly that which incorporates restorative practices, increases equity for racially and ethnically minoritized youth and informs the creation of upstream, midstream, and downstream policy interventions.

"I Just Wouldn't Like Him to go Through What I Went Through as a Kid": A Qualitative Study on the Mitigating Effects of Positive Childhood Experiences in Mothers with a History of Adverse Childhood Experiences in an Irish Population.

Adverse Childhood Experiences (ACEs) are increasingly being acknowledged as a major risk factor for instigating and sustaining cycles of trauma between mother and child. Recently, the concept of Benevolent Childhood Experiences (BCEs) has been introduced to ACEs research as a buffer against the transmission of ACEs between generations. Positive childhood experiences such as attachment to caregivers, positive peer relations and positive sense of self have been found to counteract the effects of adverse childhood experiences. The emergence of positive childhood experiences as an adaptive capacity against ACEs should be explored as a tool for psychological change, to help break the cycle of inherited trauma between generations. The present study aims to examine the lived experiences of mothers with a history of ACEs, if they consider their positive childhood experiences when parenting, and how they use these positive experiences to break the cycle of intergenerational trauma. Three women residing in a low-support service for parenting were recruited for this study. Participants were all low-income, first-time single mothers in their early thirties. A qualitative approach was designed for the study. ACEs and BCEs questionnaires were administered to participants and scores were taken into account to contextualise participant interviews. A semi-structured interview was designed in accordance with IPA guidelines. Questions were directed towards phenomenological material, focusing on participants' understanding of their experiences as mothers. Analysis of the interview data revealed three superordinate themes (replicating positive experiences, creating new positive experiences and protecting children from intergenerational trauma) related to participants' BCEs, their children's BCEs and their desire to break the cycle of intergenerational trauma. The findings of this study, namely that participants intentionally tried to create positive experiences with their own children through drawing on their own positive experiences in childhood, supports the idea that BCEs are a legitimate source of adaptive capacity for mothers with ACEs. Parenting interventions for parents with ACEs should be developed taking into account ACE and BCE scores.

Determinants of Poor Health among Workers in Criminal Justice, Community and Social Services, and Healthcare: Adverse Childhood Experiences, Workplace Trauma Exposure, and Gender Differences.

Adverse childhood experiences and workplace trauma exposure are associated with poor health. However, their differential impacts by gender are difficult to assess in studies of organizations with gender imbalances (e.g., law enforcement officers are more likely men whereas social workers are more likely women). Using a community-based participatory research framework, this study examines trauma exposure, mental and physical health, and substance use in an occupationally diverse sample (n = 391). Trauma exposure was high and associated with poor health. Even though women experienced more adversity, they were often more resilient than men. Implications for trauma-informed workplaces are discussed.

The Mediating Role of Psychological Resilience in the Relationship of Adverse Childhood Experiences With Academic Achievement.

In this study, the mediating role of psychological resilience in the relationship between negative childhood experiences and academic achievement was examined. The sample of the study consists of 405 participants who graduated from state universities in Turkey in the spring semester of 2022-2023. In the study, the Adverse Childhood Experiences Scale, the Brief Psychological Resilience Scale, and the general weighted grade point average in the university graduation transcripts of the participants were used as data collection tools. The relationships between variables were analyzed using Pearson correlation analysis and regression analysis using Process Macro (Model 4). In the regression analysis, mediation was tested with the Bootstrap technique. According to the results, there were significant negative relationships between adverse childhood experiences and academic achievement and psychological resilience, while there were significant positive relationships between psychological resilience and academic achievement. In addition, adverse childhood experiences are a predictor of academic achievement, and psychological resilience has a partial mediating role in the relationship between adverse childhood experiences and academic achievement. It is thought that the results obtained may contribute to the field within the scope of preventive and intervention guidance services to increase the academic achievement of university students with adverse childhood experiences.

Lifetime Revictimization: Evidence From the Wisconsin Longitudinal Study.

Despite the documented increasing prevalence of elder abuse victimization and its devastating health effects, a life-course view of the victimization experiences of older adults has rarely been adopted in the elder abuse literature. The current study investigated lifetime links between victimization experiences by examining the indirect effect of adverse childhood experiences (ACE) on elder abuse victimization via intimate partner violence (IPV) victimization in middle adulthood, and whether this indirect association would differ by gender. Using data from the Wisconsin Longitudinal Study, we analyzed the previous and current victimization experiences of a total of 5,391 older adults in their early 70s and estimated mediational and moderated mediation models. The key results indicated that a higher ACE score was associated with exposure to IPV victimization in middle adulthood, which was in turn associated with exposure to elder abuse victimization. This indirect association was stronger for women than for men. Regarding specific types of childhood victimization, parental physical abuse, sexual abuse, and witnessing domestic violence significantly predicted elder abuse victimization via IPV victimization. Our results support the phenomenon of lifetime victimization, whereby an individual experiences reoccurring forms of victimization across the life course from childhood to late adulthood. Findings highlight the compelling need for the assessment of cumulative victimization experiences and their impact on elder abuse victims. A life-course-based, trauma-informed approach would greatly enhance prevention and intervention services for elder abuse.

Adverse childhood experiences and alexithymia intensity as predictors of temporal dynamics of functioning in individuals with irritable bowel syndrome: A three-wave latent transition analysis.

OBJECTIVE: Despite high prevalence of irritable bowel syndrome (IBS) and its significant negative impact on individuals' quality of life, its etiology remains poorly understood. This prospective study explored whether early life factors (adverse childhood experiences; ACEs) and alexithymia intensity, could explain IBS symptom severity and its effects on psychological functioning over time. We also compared the studied variables between an IBS sample and a healthy control group. METHOD: Based on the Rome III Diagnostic Criteria for IBS, 245 individuals with a diagnosis of IBS were recruited from a national sample of Poles. The IBS sample completed the following psychometric questionaries in three waves, one month apart: Adverse Childhood Experiences Questionnaire, Toronto Alexithymia Scale, IBS Symptom Severity Score, Short Form Perceived Stress Scale, and Ultra-Brief Patient Health Questionnaire for Anxiety and Depression. Latent transition analysis was used to identify distinct profiles of IBS symptom dynamics. RESULTS: The IBS group reported a significantly higher number of ACEs, greater alexithymia severity, and more intense levels of stress, anxiety, and depressive symptoms compared to the healthy controls. Four profiles of IBS individuals with distinct dynamics of IBS symptoms, stress, anxiety, and depressive symptoms were extracted, which correlated with the baseline number of ACEs and alexithymia intensity among participants. CONCLUSION: Childhood adversity and associated problems in emotional processing affect IBS symptom severity. ACEs should be included in IBS screening and considered in the design of individualized multidisciplinary treatment approaches for IBS patients.

Perceived control ameliorates the impact of adverse childhood experiences on downstream mental health.

BACKGROUND: Previous scholarship has illustrated the pernicious role of adverse childhood experiences (ACEs) in self-reported mental health, namely depressive and anxiety-related symptoms. Given these insights, highlighting protective factors that may diminish the magnitude of this relationship is important. The present study explored the moderating role of perceived control on the relationship between ACEs and depressive and anxiety symptoms, respectively. METHODS: Participants consisted of a US-based non-clinical sample of 567 undergraduate students who completed a battery of surveys related to psychological wellbeing and individual differences. A series of hierarchical linear regression analyses were utilized for hypothesis testing. RESULTS: Consistent with our main hypotheses, perceived control moderated the relationship between ACEs and both anxiety and depressive symptoms, respectively. Namely, at low levels of perceived control, ACEs were associated with significantly greater levels of anxiety and depressive symptoms, respectively. However, for those reporting high levels of perceived control, we found no association between ACEs and self-reported symptoms. CONCLUSION: We offer evidence that perceived control may serve as a protective factor for mental health and wellbeing against the influence of adverse childhood experiences.

The impact of adverse childhood experiences on cognitive function among middle-aged and older Chinese adults: Multiple mediators of cognitive reserve and depressive symptoms.

BACKGROUND: Adverse childhood experiences (ACEs) are associated with later cognitive decline. However, the mechanisms underlying the effects of different types of ACEs are unclear. This study examined how ACEs impact cognitive function, specifically deprivation-related ACEs (DrACEs) and threat-related ACEs (TrACEs). Additionally, we explored the potential role of cognitive reserve (CR) and depression in these relationships. METHODS: Data were taken from the China Health and Retirement Longitudinal Study (CHARLS) of 2014 and 2020. CR, depressive symptoms and cognitive function measures were collected from 2020. ACEs were assessed at the 2014 Life Course Survey. The main analyses included 7113 participants aged 45 years or older. To explore potential associations, linear regression and SPSS Macro PROCESS were employed. RESULTS: Among middle-aged and older adults, only exposure to DrACEs was associated with cognitive function ((ß = -0.101 [95%CI: -0.150, -0.052]) for DrACEs = 1; (ß = -0.250 [95%CI: -0.333, -0.167]) for DrACEs ≥ 2). The indirect effects mediated by CR and depressive symptoms were statistically significant. LIMITATIONS: The use of retrospective self-reported data for ACEs may introduce recall bias. CONCLUSIONS: Chinese middle-aged and older adults who have experienced DrACEs exhibit poorer cognitive function, while the association between TrACEs and cognitive function was not significant. And the impact of DrACEs on cognitive function was mediated by CR and depressive symptoms. Further research is necessary to validate our findings, establish causal links, and uncover the underlying mechanisms involved.

The association between poverty and longitudinal patterns of adverse childhood experiences across childhood and adolescence: Findings from a prospective population-based cohort study in the UK.

BACKGROUND: Adverse childhood experiences (ACEs) affect up to half the general population, they are known to co-occur, and are particularly common among those experiencing poverty. Yet, there are limited studies examining specific patterns of ACE co-occurrence considering their developmental timing. OBJECTIVE: To examine the longitudinal co-occurrence patterns of ACEs across childhood and adolescence, and to examine the role of poverty in predicting these. PARTICIPANTS AND SETTING: The sample was 8859 children from the Avon Longitudinal Study of Parents and Children, a longitudinal prospective population-based UK birth cohort. METHODS: Repeated measures of ten ACEs were available, occurring in early childhood (birth-5 years), mid-childhood (6-10 years), and adolescence (11-16 years). Latent class analysis was used to identify groups of children with similar developmental patterns of ACEs. Multinomial regression was used to examine the association between poverty during pregnancy and ACE classes. RESULTS: Sixteen percent of parents experienced poverty. A five-class latent model was selected: "Low ACEs" (72·0 %), "Early and mid-childhood household disharmony" (10·6 %), "Persistent parental mental health problems" (9·7 %), "Early childhood abuse and parental mental health problems" (5·0 %), and "Mid-childhood and adolescence ACEs" (2·6 %). Poverty was associated with a higher likelihood of being in each of the ACE classes compared to the low ACEs reference class. The largest effect size was seen for the "Early and mid-childhood household disharmony" class (OR 4·70, 95 % CI 3·68-6·00). CONCLUSIONS: A multifactorial approach to preventing ACEs is needed - including support for parents facing financial and material hardship, at-risk families, and timely interventions for those experiencing ACEs.

Exploring the relationship between adverse childhood experiences and HPV vaccination in a national sample of adults.

BACKGROUND: Over 60 % of U.S. adults report adverse childhood experience (ACE), which correlate with risky health behaviors and lower utilization of healthcare preventive measures, potentially leading to chronic diseases in later life. OBJECTIVE: This study investigates the relationship between ACEs and human papillomavirus (HPV) vaccination in a national U.S. adult sample. PARTICIPANTS AND SETTING: We used data from selected states from the Centers for Disease Control and Prevention Behavioral Risk Factor Surveillance System collected in years 2019 (Mississippi, South Carolina, and Tennessee), 2020 (Georgia, Mississippi, North Dakota, South Carolina), 2021 (Mississippi), and 2022 (Arkansas) (N = 3578, 4392, 904, and 810, respectively). METHODS: We conducted descriptive, univariate, and multivariable regression analysis using SAS 9.4. Independent and dependent variables were ACEs and HPV vaccination, respectively. RESULTS: Individuals with ≥4 ACEs, versus no ACEs, were significantly more likely to report HPV vaccination in 2019, 2020, and 2021 (OR = 1.40, 1.77, 2.80, all p < 0.05 respectively), except in 2022 (OR = 1.54, p = 0.165). In 2019, specific ACE types, emotional abuse, and household mental illness were associated with HPV vaccination, whereas in 2021, emotional abuse, household mental illness, incarcerated household member, and substance abuse in household, and in 2022, emotional abuse was associated with HPV vaccination. CONCLUSIONS: We found mostly positive association between ACEs and HPV vaccination, particularly in initial three years. However, findings in 2022 were not significant, except for emotional abuse. Diverse patterns in relationship between ACEs and HPV vaccination was observed overtime, highlighting the need for consistency in ACEs and HPV vaccination data collection, including vaccination timing, to better understand the underlying mechanisms and plan for interventions to prevent HPV-related cancers among these populations.

Adverse childhood experiences: A health risk in emerging adulthood.

Adverse Childhood Experiences (ACEs) represent a child's exposure to negative events that are detrimental to their mental and physical health. Despite this, very few studies have focused on the relationship between ACEs and physical health problems, in non-English-speaking populations and in emerging adulthood. Therefore, the objective of this study was to investigate the cumulative and differential impact of ACEs on diverse physical health problems in a Spanish population. Participants were 648 young adults (22% men), between the ages of 18 and 30 (mean age = 21.37, SD = 3.11), who completed the ACE Questionnaire and answered some questions about their health (e.g. asthma, obesity, global health). From the cumulative perspective, ACEs had a significant relationship with global health and asthma. Additionally, the differential approach revealed some specific ACEs related to three out of five health outcomes. Therefore, early detection of ACEs is of paramount importance to reduce their impact.