RESUMEN
OBJECTIVE: To examine associations between race, ethnicity, and parent-child nativity, and common mental health conditions among U.S. children and adolescents. METHODS: Data were from 2016 to 2019 National Survey of Children's Health, a US population-based, serial cross-sectional survey, and restricted to children who had access to health care. We used weighted multivariable logistic regression to examine the associations between race and ethnicity (Asian, Black, Hispanic, White, Other-race); mental health outcomes (depression, anxiety, and behavior/conduct problems) stratified by household generation; and between household generation and outcomes stratified by race and ethnicity, adjusting for demographics (age, sex, family income to poverty ratio, parental education), and an adverse childhood experience (ACE) score. RESULTS: When stratifying by household generation, racial and ethnic minority children generally had similar to lower odds of outcomes compared with White children, with the exception of higher odds of behavior/conduct problems among third + -generation Black children. When stratifying by race and ethnicity, third + generation children had increased odds of depression compared to their first-generation counterparts. Third + generation, racial and ethnic minority children had increased odds of anxiety and behavior/conduct problems compared with their first-generation counterparts. The associations generally remained significant after adjusting for the ACE score. CONCLUSIONS: Lower odds of common mental health conditions in racial and ethnic minority children could be due to factors such as differential reporting, and higher estimates, including those in third + generation children, could be due to factors including discrimination; systemic racism; and other factors that vary by generation and need further investigation to advance health equity.
Asunto(s)
Etnicidad , Salud Mental , Humanos , Adolescente , Estados Unidos/epidemiología , Estudios Transversales , Grupos Minoritarios , Relaciones Padres-HijoRESUMEN
Objective: To investigate the relationship between of distinct domains of childhood disadvantage and cognitive performance among older adults within the context of a middle-income country. Methods: This study used baseline data (2015/2016) from the Brazilian Longitudinal Study of Aging (ELSI), a nationally representative cohort of 9412 adults aged 50 and over. Nine childhood exposure variables were grouped into three domains (family SES, childhood health, and cultural capital), for which scores were created. Survey-weighted Ordinary Least Squares (OLS) regressions estimated the association childhood disadvantage with cognitive performance as measured by immediate memory, late memory and semantic verbal fluency. Mediation analysis assessed whether adulthood socioeconomic status (SES) mediated this relationship of interest. Results: Important disparities in cognitive performance were observed, particularly in terms of age, education, income, occupational status. Before controlling for adulthood SES in the multivariable analysis, all domains of childhood disadvantage were found to be associated with lower cognitive performance across all three measures. After inclusion of adulthood SES variables, the observed associations only remained for semantic verbal fluency. Formal mediation analysis indicated that adulthood SES mediates 47.9% (95% CI: 34.3%-78.6%) of the association between later-life verbal fluency and poor childhood health, and 49.9% (95% CI: 43.6%-57.8%) of the association between later-life verbal fluency and low childhood cultural capital. Conclusions: We found that childhood disadvantage is associated with low performance in memory tests and semantic verbal fluency tests among older Brazilians. Adulthood SES fully mediated the association between all domains of childhood disadvantage and memory performance and only partially mediated its association with verbal fluency. Our findings support policy efforts to enhance early childhood development and improve adulthood SES, and guide additional research to better the mechanisms driving these relationships.
RESUMEN
Exposure to childhood adversity has been consistently associated with poor developmental outcomes, but it is unclear whether these associations vary across different forms of adversity. We examined cross-sectional and longitudinal associations between threat and deprivation with cognition, emotional processing, and psychopathology in a middle-income country. The sample consisted of 2511 children and adolescents (6-17 years old) from the Brazilian High-Risk Cohort for Mental Conditions. Parent reports on childhood adversity were used to construct adversity latent constructs. Psychopathology was measured by the Child Behavior Checklist (CBCL) to generate a measure of general psychopathology (the "p" factor). Executive function (EF) and attention orienting toward angry faces were assessed using cognitive tasks. All measures were acquired at two time-points 3 years apart and associations were tested using general linear models. Higher levels of psychopathology were predicted by higher levels of threat cross-sectionally and longitudinally, and by deprivation longitudinally. For EF, worse performance was associated only with deprivation at baseline and follow-up. Finally, threat was associated with attention orienting towards angry faces cross-sectionally, but neither form of adversity was associated with changes over time in attention bias. Our results suggest that threat and deprivation have differential associations with cognitive development and psychopathology. Exposure to adversity during childhood is a complex phenomenon with meaningful influences on child development. Because adversity can take many forms, dimensional models might help to disentangle the specific developmental correlates of different types of early experience. A video abstract of this article can be viewed at https://www.youtube.com/watch?v=uEU0L8exyTM.
Asunto(s)
Cognición , Emociones , Niño , Adolescente , Humanos , Estudios Transversales , Función Ejecutiva , Desarrollo InfantilRESUMEN
BACKGROUND: Exposure to childhood adversities (CA) is associated with sleep disturbances; however, evidence has largely been drawn from cross-sectional data and has not addressed the relationship across developmental stages. Also, most studies have primarily focused on non-Hispanic White cohorts with a dearth of longitudinal evidence about racial/ethnic minorities. We examined the longitudinal association between CA and sleep disturbances in Puerto Rican youth. METHOD: The Boricua Youth Study is a longitudinal study of Puerto Rican youth living in San Juan, Puerto Rico, and the South Bronx, NY (N = 2491). Among youth 5-9 and 10-16 years old, sleep disturbances were assessed through three yearly interviews. Lifetime exposure to CA included parental loss, child maltreatment, parental maladjustment, and exposure to violence. Weighted generalized linear mixed models examined the longitudinal association between CA and sleep disturbances in youth adjusting for sociodemographic and contextual covariates. RESULTS: The prevalence of sleep disturbances was similar in both age groups (ages 5-9 and 10-16). In multivariable mixed models, CA were associated with sleep disturbance across three Waves among 10-16-year-olds. For example, having 2-3 or ≥ 4 types of CA were related to a higher prevalence of trouble falling/staying asleep in models adjusting for social context, gender, welfare status, or mother's education. No associations were observed among 5-9-year-olds. CONCLUSION: The results suggest that cumulative adversities in childhood may lead to sleep problems in adolescence. These findings highlight the utility of addressing CA during childhood to help reduce sleep-wake disorders throughout adolescence, a known risk factor for future mental and physical health problems.
Asunto(s)
Hispánicos o Latinos , Trastornos del Sueño-Vigilia , Adolescente , Niño , Estudios Transversales , Humanos , Estudios Longitudinales , Puerto Rico/epidemiología , Sueño , Trastornos del Sueño-Vigilia/epidemiologíaRESUMEN
Objective: We investigated: i) the reliability and validity of a Brazilian version of the Community Assessment of Psychic Experiences (CAPE), developed to detect and characterize psychotic experiences in the general population; and ii) the association between psychotic experiences, childhood adversity, and cannabis use in a population-based sample. Methods: We performed factorial analyses and generalized linear models with CAPE scores as the dependent variable in a sample composed of 217 first-episode psychosis patients, 104 unaffected biological siblings, and 319 non-psychotic population-based participants. Results: After removing seven items from its positive dimension and two items from its negative dimension, a 33-item Brazilian version of the CAPE showed acceptable adjustment indices (confirmatory fit index = 0.895; goodness of fit index = 0.822; parsimony goodness of fit index = 0.761; root mean square error of approximation [RMSEA] = 0.055, p [RMSEA ≤ 0.05] = 0.04) and internal consistency in all its dimensions (> 0.70). Childhood adversity was associated with higher scores in all three dimensions, as well as with total score. Lifetime cannabis use was associated with higher scores only in the positive dimension. Conclusion: The proposed Brazilian version of the CAPE corroborates the tridimensional approach for assessing psychosis-proneness, and the frequency and severity of psychotic manifestations are distributed as a spectrum in the general population.
Asunto(s)
Humanos , Masculino , Femenino , Escalas de Valoración Psiquiátrica/normas , Trastornos Psicóticos/diagnóstico , Encuestas y Cuestionarios/normas , Portugal , Psicometría , Trastornos Psicóticos/psicología , Brasil , Valor Predictivo de las Pruebas , Reproducibilidad de los Resultados , Servicios Comunitarios de Salud MentalRESUMEN
BACKGROUND: Childhood adversities are prevalent worldwide and might affect adult cardiovascular health. However, in middle-income countries such as Mexico, research on the impact of childhood adversities on cardiovascular disease (CVD) in adulthood is lacking. OBJECTIVE: To evaluate the prevalence of adverse childhood experiences (ACEs) and their association with risk factors for CVD in adult Mexican women. PARTICIPANTS AND SETTING: The study population comprised 9853 women from the Mexican Teachers´ Cohort. METHODS: Participants responded to an online questionnaire including a 10-item instrument on ACEs and questions on CVD risk factors, between 2014 and 2017. Multivariate logistic regression models were used to evaluate the association between ACEs and adult behavioral and medical CVD risk factors. RESULTS: About 61% of participants reported at least one ACE and 14% reported four or more. After multivariable adjustment, women who reported ≥4 ACEs had 58% (95%CI 1.37, 1.81) higher odds of having ever smoked and 17% (95%CI 0.69, 0.99) lower odds of being physically active, compared with women who reported no ACEs. Women who reported ≥4 ACEs also had higher odds of hypertension (OR = 1.19; 95%CI 1.00, 1.43), diabetes (OR = 1.49; 95%CI 1.13, 1.96), high cholesterol (OR = 1.49; 95%CI 1.26, 1.75), and obesity (OR = 1.37; 95%CI 1.19, 1.57). In addition, individual ACE components were independently associated with several CVD risk factors. CONCLUSION: ACEs are common and associated with CVD risk factors in adult Mexican women.
Asunto(s)
Experiencias Adversas de la Infancia , Enfermedades Cardiovasculares/etiología , Adulto , Experiencias Adversas de la Infancia/estadística & datos numéricos , Niño , Femenino , Humanos , Modelos Logísticos , México , Persona de Mediana Edad , Obesidad , Prevalencia , Factores de Riesgo , Encuestas y CuestionariosRESUMEN
Las experiencias adversas durante la infancia pueden constituirse en eventos traumáticos que impactan la calidad de los vínculos y la salud mental a lo largo del ciclo vital, siendo la depresión un trastorno frecuente en quienes reportan estas vivencias. La depresión ha sido asociada positivamente a la adversidad temprana y negativamente con la satisfacción de pareja durante la adultez, pero se desconoce el valor explicativo de la adversidad temprana y la depresión en los niveles de satisfacción de pareja. Considerando estos antecedentes, se desarrolló un estudio transversal, correlacional y comparativo en 160 madres y padres chilenos(as). Los resultados mostraron altos niveles de satisfacción de pareja y una asociación positiva entre las experiencias adversas y la depresión en padres y madres. Las madres presentaron mayores puntajes que los padres en depresión [t(79) =4.72, p<.001] y en experiencias adversas tempranas [t(79)= 3.468, p<.001], explicando la depresión materna y paterna junto a la satisfacción de pareja paterna un 51.8% de la satisfacción de pareja en las mujeres. En cuanto a los padres, su sintomatología depresiva y la satisfacción de la madre, explicaron un 58.9% de su satisfacción de pareja. Se discute la relevancia y las implicancias clínicas de los resultados
Adverse experiences in childhood are often traumatic events that affect relationships and mental health throughout the life cycle, with depression being a prevalent disorder in those who report them. Although depression has been positively associated with early adver-sity and negatively with couple satisfaction during adulthood, there are no studies that evaluate the explanatory value of both variables at the level of couple satisfaction. Therefore, a cross-sectional, correlational and comparative study was carried out in 160 fathers and mothers. The results showed high levels of couple satisfaction and a positive association between childhood adverse experiences and depression in parents. Mothers showed higher scores than fathers in depression [t(79) = 4.72; p <, 001] and in childhood adverse experiences [t(79) = 3,468 p <.001]. Moreover, for them, depression explained 53% of couple satisfaction. As for the father, a depressive symptomatology, childhood adverse experiences and the mother's depressive symptomatology explained 35% of his couple satisfaction
Asunto(s)
Humanos , Masculino , Femenino , Adulto , Persona de Mediana Edad , Padres/psicología , Satisfacción Personal , Esposos/psicología , Depresión , Factores de Tiempo , Parejas Sexuales , Modelos Lineales , Estudios Transversales , Escolaridad , Correlación de Datos , Relaciones InterpersonalesRESUMEN
OBJECTIVE: To estimate the prevalence of adverse childhood experiences in low-income Latino children and examine differences in the prevalence of adverse childhood experiences by immigrant generational status. STUDY DESIGN: This is a secondary data analysis of the 2011-2012 National Survey of Children's Health, a telephone survey of parents/caregivers of a nationally representative sample of US children. The study sample was limited to Latino children in households with an annual income ≤200% of the federal poverty level (FPL) whose parents responded to a 9-item inventory of adverse childhood experiences. Descriptive statistics estimated the prevalence of adverse childhood experiences and examined differences in prevalence by immigrant generational status. RESULTS: Of 22 297 children, 29% (n = 6483) were Latino (9% first generation, 57% second generation, 30% third or higher generation); 25% (n = 1692) of all Latino children were exposed to 2 or more adverse childhood experiences. Latino immigrant children had a lower prevalence (13%; n = 801) compared with nonimmigrant Latino children (40%; n = 772). The most common adverse childhood experiences were financial hardship and parent divorce/separation. The total number and mean number of adverse childhood experiences differed by child generational status, and the differences persisted after stratification by age and FPL. The prevalence of exposure to adverse childhood experiences was highest among third- or higher-generation nonimmigrant children and lowest among second-generation immigrant children. CONCLUSIONS: The prevalence of adverse childhood experiences in low-income Latino children is similar to the prevalence for all US children; however, the prevalence is significantly higher in nonimmigrant children. Targeted screening to address adverse childhood experiences, policy changes, and guidance regarding care practices to address adverse childhood experiences in Latino children are needed.
Asunto(s)
Emigrantes e Inmigrantes/estadística & datos numéricos , Hispánicos o Latinos/estadística & datos numéricos , Acontecimientos que Cambian la Vida , Pobreza/estadística & datos numéricos , Adolescente , Niño , Preescolar , Estudios Transversales , Divorcio/estadística & datos numéricos , Femenino , Encuestas Epidemiológicas , Humanos , Lactante , Recién Nacido , Masculino , Prevalencia , Estados Unidos/epidemiologíaRESUMEN
OBJECTIVE: The study aim was to assess the cumulative burden of polymorphisms located within four genetic loci previously associated with posttraumatic stress disorder (PTSD) among outpatients at risk for PTSD. METHODS: Diagnostic interviews were completed and DNA samples collected among 412 pain patients to determine if FKBP5 (rs9470080), COMT (rs4680), CHRNA5 (rs16969968), and CRHR1 (rs110402) single nucleotide polymorphisms were cumulatively associated with increased risk for PTSD. RESULTS: In bivariate analyses, it was found that a count of specific PTSD risk alleles located within FKBP5, COMT, CHRNA5, and CRHR1 genetic loci (allele range = 0-6, mean count = 2.92, standard deviation = 1.36) was associated with lifetime (t [409] = 3.430, P = 0.001) and early onset PTSD (t [409] = 4.239, P = 0.000028). In logistic regression, controlling for demographic factors, personality traits, and trauma exposures, this risk allele count remained associated with both lifetime (odds ratio = 1.49, P = 0.00158) and early onset PTSD (odds ratio = 2.36, P = 0.000093). Interaction effects were also detected, whereby individuals with higher risk allele counts and higher trauma exposures had an increased risk of lifetime PTSD (allele count × high trauma, P = 0.026) and early onset PTSD (allele count × high trauma, P = 0.016) in these logistic regressions. Those with no or few risk alleles appeared resilient to PTSD, regardless of exposure history. CONCLUSION: A cumulative risk allele count involving four single nucleotide polymorphisms located within the FKBP5, COMT, CHRNA5, and CRHR1 genes are associated with PTSD. Level of trauma exposure interacts with risk allele count, such that PTSD is increased in those with higher risk allele counts and higher trauma exposures. Since the single nucleotide polymorphisms studied encompass stress circuitry and addiction biology, these findings may have implications for neuropsychiatric research and treatment.