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1.
JAMA Netw Open ; 5(9): e2230690, 2022 Sep 01.
Artículo en Inglés | MEDLINE | ID: mdl-36066889

RESUMEN

Importance: Accelerated aging makes adults more vulnerable to chronic diseases and death. Whether childhood adversity is associated with accelerated aging processes, and to what extent lifestyle mediates the association, remain unknown. Objective: To examine the associations of childhood adversity with a phenotypic aging measure and the role of unhealthy lifestyle in mediating these associations. Design, Setting, and Participants: A retrospective cohort analysis was conducted using data from adult participants in the UK Biobank baseline survey (2006-2010) and online mental health survey (2016). Data analysis was performed from September 1, 2021, to February 28, 2022. Exposures: Childhood adversity, including physical neglect, emotional neglect, sexual abuse, physical abuse, and emotional abuse, was assessed retrospectively through the online mental health survey (2016). Main Outcomes and Measures: A phenotypic aging measure, phenotypic age acceleration, was calculated, with higher values indicating accelerated aging. Body mass index, smoking status, alcohol consumption, physical activity, and diet were combined to construct an unhealthy lifestyle score (range, 0-5, with higher scores denoting a more unhealthy lifestyle). Results: A total of 127 495 participants aged 40 to 69 years (mean [SD] chronological age at baseline, 56.4 [7.7] years; 70 979 women [55.7%]; 123 987 White participants [97.2%]) were included. Each individual type of childhood adversity and cumulative childhood adversity score were associated with phenotypic age acceleration. For instance, compared with participants who did not experience childhood adversity, those who experienced 4 (ß = 0.296, 95% CI, 0.130-0.462) or 5 (ß = 0.833; 95% CI, 0.537-1.129) childhood adversities had higher phenotypic age acceleration in fully adjusted models. The formal mediation analysis revealed that unhealthy lifestyle partially mediated the associations of childhood adversity with phenotypic age acceleration by 11.8% to 42.1%. Conclusions and Relevance: In this retrospective cohort study, childhood adversity was significantly associated with acceleration of aging and, more importantly, unhealthy lifestyle partially mediated these associations. These findings reveal a pathway from childhood adversity to health in middle and early older adulthood through lifestyle and underscore the potential of more psychological strategies beyond lifestyle interventions to promote healthy aging.


Asunto(s)
Experiencias Adversas de la Infancia , Bancos de Muestras Biológicas , Aceleración , Adulto , Anciano , Femenino , Humanos , Estilo de Vida , Estudios Retrospectivos , Reino Unido/epidemiología
2.
Transl Psychiatry ; 12(1): 392, 2022 Sep 17.
Artículo en Inglés | MEDLINE | ID: mdl-36115855

RESUMEN

Structural differences in the dorsolateral prefrontal cortex (DLPFC), anterior cingulate cortex (ACC), hippocampus, and amygdala were reported in adults who experienced childhood trauma; however, it is unknown whether metabolic differences accompany these structural differences. This multimodal imaging study examined structural and metabolic correlates of childhood trauma in adults with major depressive disorder (MDD). Participants with MDD completed the Childhood Trauma Questionnaire (CTQ, n = 83, n = 54 female (65.1%), age: 30.4 ± 14.1) and simultaneous positron emission tomography (PET)/magnetic resonance imaging (MRI). Structure (volume, n = 80, and cortical thickness, n = 81) was quantified from MRI using Freesurfer. Metabolism (metabolic rate of glucose uptake) was quantified from dynamic 18F-fluorodeoxyglucose (FDG)-PET images (n = 70) using Patlak graphical analysis. A linear mixed model was utilized to examine the association between structural/metabolic variables and continuous childhood trauma measures while controlling for confounding factors. Bonferroni correction was applied. Amygdala volumes were significantly inversely correlated with continuous CTQ scores. Specifically, volumes were lower by 7.44 mm3 (95% confidence interval [CI]: -12.19, -2.68) per point increase in CTQ. No significant relationship was found between thickness/metabolism and CTQ score. While longitudinal studies are required to establish causation, this study provides insight into potential consequences of, and therefore potential therapeutic targets for, childhood trauma in the prevention of MDD. This work aims to reduce heterogeneity in MDD studies by quantifying neurobiological correlates of trauma within MDD. It further provides biological targets for future interventions aimed at preventing MDD following trauma. To our knowledge, this is the first simultaneous positron emission tomography (PET) and magnetic resonance imaging (MRI) study to assess both structure and metabolism associated with childhood trauma in adults with MDD.


Asunto(s)
Experiencias Adversas de la Infancia , Trastorno Depresivo Mayor , Adolescente , Adulto , Encéfalo/diagnóstico por imagen , Encéfalo/patología , Trastorno Depresivo Mayor/diagnóstico por imagen , Trastorno Depresivo Mayor/patología , Femenino , Fluorodesoxiglucosa F18 , Glucosa , Humanos , Adulto Joven
4.
Zhong Nan Da Xue Xue Bao Yi Xue Ban ; 47(8): 1163-1170, 2022 Aug 28.
Artículo en Inglés, Chino | MEDLINE | ID: mdl-36097785

RESUMEN

As a global public health problem, adverse childhood experiences (ACEs) is an important factor leading to serious psychological and behavioral problems in children and adolescents. Mental health service plan based on mental health service needs is the key to effectively improve the psychological problems of children and adolescents with ACEs. Emotional support, life skills training, mental health education, and individualized psychological intervention can effectively improve the mental health of children and adolescents with ACEs. Among them, emotional support is an important way to help individual reduce psychological and behavioral problems; secondly, life skills training can significantly improve the individual's psychosocial ability; and mental health education is a necessary way to promote the development of individual mental health. Individualized psychological intervention can promote individual to obtain more professional mental health service and improve their psychological symptoms, which is crucial for preventing the occurrence of mental health problems. Future research can develop targeted mental health interventions based on the specific mental health service needs.


Asunto(s)
Experiencias Adversas de la Infancia , Servicios de Salud Mental , Adolescente , Niño , Humanos , Salud Mental
5.
Front Public Health ; 10: 876769, 2022.
Artículo en Inglés | MEDLINE | ID: mdl-36091515

RESUMEN

Adverse Childhood Experiences (ACEs) are defined as traumatic events occurring before age 18, such as maltreatment, life-threatening accidents, harsh migration experiences, or violence. Screening for ACEs includes asking questions about an individual's early exposure to these types of events. ACEs screenings have potential value in identifying children exposed to chronic and significant stress that produces elevated cortisol levels (i.e., toxic stress), and its associated physical and mental health conditions, such as heart disease, diabetes, depression, asthma, ADHD, anxiety, and substance dependence. However, ACEs screenings are seldom used in primary care settings. The Surgeon General of California has addressed this care gap by introducing ACEs Aware, an ACEs screening fee-for-service healthcare policy signed into law by Gov. Gavin Newsom. Since January 2020, Medi-Cal, California's Medicaid health care program, has reimbursed primary care providers for using the Pediatric ACEs and Related Life-events Screener (PEARLS) tool to screen children and adults for ACEs during wellness visits. To achieve the goals set by the ACEs Aware state policy, it is essential to develop and test implementation strategies that are informed by the values, priorities, and resources of clinical settings, healthcare professionals, and end-users. To address this need, we partnered with a system of federally qualified health centers in Southern California on a pilot study to facilitate the implementation of ACEs screenings in five community-based clinics. The health centers had broad ideas for an implementation strategy, as well as best practices to improve adoption of screenings, such as focusing on staff training to improve clinic workflow. This knowledge was incorporated into the development of an implementation strategy template, used at the outset of this study. We used the Exploration, Preparation, Implementation and Sustainment (EPIS) framework to guide the study and inform a participatory planning process called Implementation Mapping. In this paper, we describe how Implementation Mapping was used to engage diverse stakeholders and guide them through a systematic process that resulted in the development of the implementation strategy. We also detail how the EPIS framework informed each Implementation Mapping Task and provide recommendations for developing implementation strategies using EPIS and Implementation Mapping in health-care settings.


Asunto(s)
Experiencias Adversas de la Infancia , Adolescente , Adulto , California , Niño , Política de Salud , Humanos , Tamizaje Masivo/métodos , Proyectos Piloto , Estados Unidos
6.
Artículo en Inglés | MEDLINE | ID: mdl-36078291

RESUMEN

Adverse childhood experiences (ACEs) increase the risk of poor health and wellbeing in adulthood. In this study, we tested whether experiences in early adulthood-intimate partner violence (IPV), substance use, social isolation, and work instability-mediate the relationship between ACEs and poor physical health in later adulthood. Using data from a large-scale survey of Medicaid enrollees in the Portland metropolitan area, four separate mediation models were constructed to assess the indirect effects of each early adulthood experience and the proportion of the total effect on physical health accounted for by the pathway. Experiencing four or more ACEs increased the risk of poor adult physical health by 50% (RR 1.50). Considered in separate models, mediation by IPV accounted for 14.4% of the total effect; substance use mediated a similar proportion (14.0%). Social isolation was a less substantial mediator (7.6%). Work instability did not mediate the relationship between ACEs and adult physical health in our population. These findings provide evidence that IPV, substance use, and social isolation in early adulthood are part of the pathway between high ACEs and poor adult physical health. Intervening to prevent negative early adult experiences may mitigate some of the long-term effects of childhood trauma on health.


Asunto(s)
Experiencias Adversas de la Infancia , Violencia de Pareja , Trastornos Relacionados con Sustancias , Adulto , Humanos , Pobreza , Trastornos Relacionados con Sustancias/epidemiología , Encuestas y Cuestionarios
7.
Artículo en Inglés | MEDLINE | ID: mdl-36078294

RESUMEN

The current evidence indicates that spanking is harmful to children's health and development and should never be used by parents or other caregivers. However, the critical factors that inform effective spanking prevention strategies are still not well understood. The objective of the current study was to determine if a parent's own adverse childhood experiences (ACEs) history was associated with increased likelihood of reporting their child being spanked at age 10 or younger. Data were drawn from the Well-Being and Experiences Study (the WE Study), a community survey of parents and adolescents from 2017-2018 (N = 1000) from Canada. The results indicated that a parent's own history of physical abuse, emotional abuse, spanking, and household mental illness in childhood were associated with an increased likelihood that their child would have been spanked. These findings indicate that a parent's ACEs history may be related to how their own child is parented and identify families who may be more likely to rely on spanking. Preventing physical punishment is necessary for healthy child development, reducing the risk of further violence, and upholding children's rights to protection. Parent's ACEs history may be an important factor to consider when developing and implementing child maltreatment prevention efforts.


Asunto(s)
Experiencias Adversas de la Infancia , Maltrato a los Niños , Trastornos Mentales , Adolescente , Niño , Humanos , Abuso Físico , Castigo/psicología
8.
Artículo en Inglés | MEDLINE | ID: mdl-36078386

RESUMEN

Children across all races/ethnicities and income levels experience adverse childhood experiences (ACEs); however, historically excluded children and families must contend with added adversities across ecological levels and within higher-risk conditions due to systemic inequality. In this grounded theory study, the authors examined how health and social service providers (N = 81) from rural and urban counties in Tennessee provided services to low-income families, children exposed to opioids, and children of immigrants. Guided by an intersectional framework, the authors examined how rural and urban settings shaped higher risk conditions for ACEs and impeded access to resources at the individual, group, and community levels. Findings from this study identified additionally marginalized subpopulations and demonstrated how inequitable environments intersect and compound the effects of ACEs. The authors present their Intersectional Nature of ACEs Framework to showcase the relationship between high-risk conditions and sociopolitical and economic circumstances that can worsen the effects of ACEs. Ultimately, the Intersectional Nature of Aces Framework differentiates between ACEs that are consequences of social inequities and ACEs that are inflicted directly by a person. This framework better equips ACEs scholars, policymakers, and stakeholders to address the root causes of inequality and mitigate the effects of ACEs among historically excluded populations.


Asunto(s)
Experiencias Adversas de la Infancia , Determinantes Sociales de la Salud , Humanos , Pobreza , Grupos Raciales , Población Rural
9.
Eur J Psychotraumatol ; 13(2): 2101347, 2022.
Artículo en Inglés | MEDLINE | ID: mdl-36016844

RESUMEN

Objective: The effects of maternal exposure to adverse childhood experiences (ACEs) may be transmitted to subsequent generations through various biopsychosocial mechanisms. However, studies tend to focus on exploring one or two focal pathways with less attention paid to links between different pathways. Using a network approach, this paper explores a range of core prenatal risk factors that may link maternal ACEs to infant preterm birth (PTB) and low birthweight (LBW). Methods: We used data from the Avon Longitudinal Study of Parents and Children (ALSPAC) (n = 8379) to estimate two mixed graphical network models: Model 1 was constructed using adverse infant outcomes, biopsychosocial and environmental risk factors, forms of ACEs, and sociodemographic factors. In Model 2, ACEs were combined to represent a threshold ACEs score (≥4). Network indices (i.e., shortest path and bridge expected influence [1-step & 2-step]) were estimated to determine the shortest pathway from ACEs to infant outcomes, and to identify the risk factors that are vital in activating other risk factors and adverse outcomes. Results: Network analyses estimated a mutually reinforcing web of childhood and prenatal risk factors, with each risk connected to at least two other risks. Bridge influence indices suggested that childhood physical and sexual abuse and multiple ACEs were highly interconnected to others risks. Overall, risky health behaviours during pregnancy (i.e., smoking & illicit drug use) were identified as 'active' risk factors capable of affecting (directly and indirectly) other risk factors and contributing to the persistent activation of the global risk network. These risks may be considered priority candidate targets for interventions to disrupt intergenerational risk transmission. Our study demonstrates the promise of network analysis as an approach for illuminating the intergenerational transmission of adversity in its full complexity. HIGHLIGHTS: We took a network approach to assessing links between ACEs and birth outcomes.ACEs, other prenatal risk factors, and birth outcomes had complex inter-connectionsHealth behaviours in pregnancy were indicated as optimal intervention targets.


Objetivo: Los efectos de la exposición materna a experiencias adversas en la infancia (ACEs, en sus siglas en inglés) pueden ser transmitidos a las generaciones posteriores a través de varios mecanismos biopsicosociales. Sin embargo, los estudios tienden a centrarse en la exploración de una o dos vías focales, prestando menos atención a los vínculos entre diferentes vías. Utilizando un abordaje de red, este trabajo explora una serie de factores de riesgo prenatales centrales que pueden vincular las ACEs maternas con el nacimiento prematuro (PTB, en sus siglas en inglés) y el bajo peso al nacer (LBW, en sus siglas en inglés) de los bebés.Métodos: Se utilizaron datos del Estudio Longitudinal de Padres e Hijos de Avon (ALSPAC) (n = 8.379) para estimar dos modelos de red gráfica mixta: El modelo 1 se construyó utilizando los resultados adversos del lactante, los factores de riesgo biopsicosociales y ambientales, las formas de las ACE y los factores sociodemográficos. En el modelo 2, las ACEs se combinaron para representar una puntuación de ACEs umbral (≥ 4). Se estimaron los índices de red (es decir, el camino más corto y la influencia esperada del puente [1 y 2 pasos]) para determinar el camino más corto desde las ACEs hasta los resultados infantiles, y para identificar los factores de riesgo que son vitales para activar otros factores de riesgo y resultados adversos.Resultados: Los análisis de redes estimaron una red de factores de riesgo prenatales y de la infancia que se refuerzan mutuamente, y cada riesgo está conectado con al menos otros dos riesgos. Los índices de influencia de los puentes sugirieron que el abuso físico y sexual en la infancia y los múltiples ACEs estaban altamente interconectados con otros riesgos. En general, las conductas de riesgo para la salud durante el embarazo (es decir, el tabaquismo y el consumo de drogas ilícitas) se identificaron como factores de riesgo "activos" capaces de afectar (directa e indirectamente) a otros factores de riesgo y de contribuir a la activación persistente de la red de riesgo global. Estos riesgos pueden considerarse objetivos candidatos prioritarios para las intervenciones destinadas a interrumpir la transmisión intergeneracional del riesgo. Nuestro estudio demuestra la promesa del análisis de redes como abordaje para iluminar la transmisión intergeneracional de la adversidad en toda su complejidad.


Asunto(s)
Experiencias Adversas de la Infancia , Nacimiento Prematuro , Trastornos Relacionados con Sustancias , Niño , Femenino , Humanos , Lactante , Recién Nacido , Estudios Longitudinales , Embarazo , Nacimiento Prematuro/epidemiología , Factores de Riesgo , Trastornos Relacionados con Sustancias/psicología
10.
Child Abuse Negl ; 132: 105815, 2022 Oct.
Artículo en Inglés | MEDLINE | ID: mdl-35914329

RESUMEN

OBJECTIVES: Childhood trauma (physical, emotional, sexual abuse and/or physical and emotional neglect) represents a specific risk for developmental perturbations and long-term negative outcomes. Adolescents and young adults with childhood trauma have rarely experienced a single type of traumatic event but rather multiple traumatic experiences. However, studies on adolescent PTSD are sparse. This study examines the possible mediating role of mentalizing, cognitive and interpersonal emotion regulation strategies between multiple types of childhood trauma exposure and PTSD in adolescents and young adults. METHODS: The sample consisted of 456 adolescents and young adults aged 15 and 25, recruited from four high schools and one university. Participants completed self-report questionnaires assessing childhood trauma, mentalizing, cognitive and interpersonal strategies of emotion regulation and PTSD. RESULTS: Structural Equation Modeling revealed that multiple types of childhood trauma exposure have a significant indirect effect on PTSD symptoms through its association with hypomentalizing and maladaptive cognitive strategies of emotion regulation (i.e. self-blame, rumination, catastrophizing). Results also showed a significant indirect effect between multiple types of childhood trauma exposure and PTSD symptoms through its association with hypomentalizing and maladaptive interpersonal strategies of emotion regulation (i.e. emotional reactivity and tendency to avoid emotional connection). Indirect paths were also run in reverse to control for the direction of the effect. CONCLUSION: Our findings show that exposure to multiple types of childhood trauma contributes to severe PTSD through several complex pathways including both hypomentalizing and maladaptive emotion regulation strategies in adolescence and young adulthood.


Asunto(s)
Experiencias Adversas de la Infancia , Regulación Emocional , Mentalización , Trastornos por Estrés Postraumático , Adolescente , Adulto , Emociones , Humanos , Adulto Joven
11.
Eur J Psychotraumatol ; 13(2): 2105580, 2022.
Artículo en Inglés | MEDLINE | ID: mdl-35928521

RESUMEN

Background: The study examined the psychometric properties of the Child and Adolescent Trauma Screen 2 (CATS-2) as a measure of posttraumatic stress disorder (PTSD) according to DSM-5 and (Complex) PTSD following the ICD-11 criteria in children and adolescents (7-17 years). Methods: Psychometric properties were investigated in an international sample of traumatized children and adolescents (N = 283) and their caregivers (N = 255). We examined the internal consistency (α), convergent and discriminant validity, the factor structure of the CATS-2 total scores, latent classes of PTSD/Complex PTSD (CPTSD) discrimination, as well as the diagnostic utility using ROC-curves. Results: The DSM-5 total score (self: α = .89; caregiver: α = .91), the ICD-11 PTSD total score (self: α = .67; caregiver: α = .79) and the ICD-11 CPTSD total score (self: α = .83; caregiver: α = .87) have proven acceptable to excellent reliability. The latent structure of the 12-item ICD-11 PTSD/CPTSD construct was consistent with prior findings. Latent profile analyses revealed that ICD-11 CPTSD was empirically distinguishable from ICD-11 PTSD using the CATS-2. ROC-analysis using the CAPS-CA-5 as outcome revealed that CATS-2 DSM-5 PTSD scores of ≥21 (screening) to ≥25 (diagnostic) were optimally efficient for detecting probable DSM-5 PTSD diagnosis. For the ICD-11 PTSD scale scores of ≥7 (screening) to ≥9 (diagnostic) were optimally efficient for detecting probable DSM-5 PTSD diagnosis. Conclusions: The CATS-2 is a brief, reliable and valid measure of DSM-5 PTSD, ICD-11 PTSD and CPTSD symptomatology in traumatized children and adolescents, allowing crosswalk between diagnostic systems using one measure. HIGHLIGHTS: The CATS-2 screens for potentially traumatic events (PTEs) and PTSD symptoms.The CATS-2 captures DSM-5 and ICD-11 criteria for PTSD and CPTSD and enables clinicians and researchers to crosswalk between both diagnostic systems.International validation has proven good psychometric properties and presents cut-off scoresThe CATS-2 is a license-free instrument and is freely accessible.


Asunto(s)
Experiencias Adversas de la Infancia , Trastornos por Estrés Postraumático , Manual Diagnóstico y Estadístico de los Trastornos Mentales , Humanos , Clasificación Internacional de Enfermedades , Reproducibilidad de los Resultados , Trastornos por Estrés Postraumático/diagnóstico
13.
Transl Psychiatry ; 12(1): 306, 2022 08 01.
Artículo en Inglés | MEDLINE | ID: mdl-35915071

RESUMEN

Early life adversity (ELA) is a major risk factor for mental illness, but the neurobiological mechanisms by which ELA increases the risk for future psychopathology are still poorly understood. Brain development is particularly malleable during prenatal and early postnatal life, when complex neural circuits are being formed and refined through an interplay of excitatory and inhibitory neural input, synaptogenesis, synaptic pruning, myelination, and neurogenesis. Adversity that influences these processes during sensitive periods of development can thus have long-lasting and pervasive effects on neural circuit maturation. In this review, we will discuss clinical and preclinical evidence for the impact of ELA on neural circuit formation with a focus on the early postnatal period, and how long-lasting impairments in these circuits can affect future behavior. We provide converging evidence from human and animal studies on how ELA alters the functional development of brain regions, neural circuits, and neurotransmitter systems that are crucial for cognition and affective behavior, including the hippocampus, the hypothalamus-pituitary-adrenal (HPA) axis, neural networks of fear responses and cognition, and the serotonin (5-HT) system. We also discuss how gene-by-environment (GxE) interactions can determine individual differences in susceptibility and resilience to ELA, as well as molecular pathways by which ELA regulates neural circuit development, for which we emphasize epigenetic mechanisms. Understanding the molecular and neurobiological mechanisms underlying ELA effects on brain function and psychopathology during early postnatal sensitive periods may have great potential to advance strategies to better treat or prevent psychiatric disorders that have their origin early in life.


Asunto(s)
Experiencias Adversas de la Infancia , Animales , Femenino , Humanos , Sistema Hipotálamo-Hipofisario , Sistema Hipófiso-Suprarrenal , Embarazo , Psicopatología , Serotonina , Estrés Psicológico/metabolismo
14.
Transl Psychiatry ; 12(1): 326, 2022 08 10.
Artículo en Inglés | MEDLINE | ID: mdl-35948532

RESUMEN

Early life stress (ELS) induces long-term phenotypic adaptations that contribute to increased vulnerability to a host of neuropsychiatric disorders. Epigenetic mechanisms, including DNA methylation, histone modifications and non-coding RNA, are a proposed link between environmental stressors, alterations in gene expression, and phenotypes. Epigenetic modifications play a primary role in shaping functional differences between cell types and can be modified by environmental perturbations, especially in early development. Together with contributions from genetic variation, epigenetic mechanisms orchestrate patterns of gene expression within specific cell types that contribute to phenotypic variation between individuals. To date, many studies have provided insights into epigenetic changes resulting from ELS. However, most of these studies have examined heterogenous brain tissue, despite evidence of cell-type-specific epigenetic modifications in phenotypes associated with ELS. In this review, we focus on rodent and human studies that have examined epigenetic modifications induced by ELS in select cell types isolated from the brain or associated with genes that have cell-type-restricted expression in neurons, microglia, astrocytes, and oligodendrocytes. Although significant challenges remain, future studies using these approaches can enable important mechanistic insight into the role of epigenetic variation in the effects of ELS on brain function.


Asunto(s)
Experiencias Adversas de la Infancia , Encéfalo , Metilación de ADN , Epigénesis Genética , Epigenómica , Humanos , Estrés Psicológico/metabolismo
16.
Artículo en Inglés | MEDLINE | ID: mdl-35955095

RESUMEN

The southern region of the United States, often referred to as the Deep South, is disproportionately affected by HIV. In fact, the highest rates of new HIV infections occur in the Deep South. Approximately one in five new HIV infections are among youth. Youth living with HIV (YLWH) have several behavioral health risks, including co-occurring mental health and substance abuse disorders, which negatively affect medication adherence, contribute to less engagement in HIV care, and result in poor health outcomes. Research suggests that adverse childhood experiences (ACEs) contribute to HIV risk behaviors and that people living with HIV may be more vulnerable to the negative health outcomes and adverse effects of stressors. Using existing program evaluation data, we examined data from 41 YLWH aged 17-24 screened for ACEs in an integrated care setting. Most participants were Black/African American young men who identified as homosexual, bisexual, or questioning, and who acquired HIV behaviorally. Approximately, one-third of YLWH screened positive or in the high-risk range on an ACEs screener. Scores fell in the intermediate range for nearly half of the sample. Results did not reveal a significant relationship between ACEs and HIV biological indicators. In this paper, we describe these findings and the importance of incorporating trauma-informed approaches into HIV prevention and treatment programs targeting youth in the Deep South.


Asunto(s)
Experiencias Adversas de la Infancia , Infecciones por VIH , Trastornos Relacionados con Sustancias , Adolescente , Infecciones por VIH/psicología , Humanos , Masculino , Cumplimiento de la Medicación/psicología , Salud Mental , Trastornos Relacionados con Sustancias/epidemiología
17.
J Child Psychol Psychiatry ; 63(9): 961-962, 2022 Sep.
Artículo en Inglés | MEDLINE | ID: mdl-35950532

RESUMEN

The deleterious developmental effects of exposure to early adversity have been well documented in the scientific literature. The finding that poverty in early childhood is among the most robust predictors of a range of poor developmental outcomes has been well known for decades. More recently, evidence that early experiences of poverty and related forms of adversity negatively impact the function and structure of the developing brain have also emerged. Retrospective studies linking poor physical health outcomes to adverse childhood experiences (ACES) highlighted the more global nature of these risk factors to wellbeing and follow-up prospective studies have since confirmed these findings (Brown et al., 2009). Alternatively, it has become increasingly clear that early experiences of stimulation, nurturance, and caregiver support promote positive development outcomes with emerging evidence for tangible impacts on neurodevelopment in humans (Luby et al., 2021). However, the scientific and public health community has yet to synthesize these related bodies of data and develop a plan of action related to their over-reaching and global importance to protecting and promoting childhood health and development more generally despite numerous calls to do just that (Farah, 2018; Luby et al., 2020).


Asunto(s)
Experiencias Adversas de la Infancia , Niño , Preescolar , Humanos , Estudios Prospectivos , Estudios Retrospectivos , Factores de Riesgo
18.
BMJ Open ; 12(8): e060395, 2022 08 25.
Artículo en Inglés | MEDLINE | ID: mdl-36008078

RESUMEN

OBJECTIVE: To examine and synthesise the literature on adverse childhood experience (ACE) screening in clinical and healthcare settings servicing children (0-11) and young people (12-25). DESIGN: A systematic review of literature was undertaken. DATA SOURCE: PsycInfo, Web of Science, Embase, PubMed and CINAHL were searched through June 2021. Additional searches were also undertaken. ELIGIBILITY CRITERIA: English language studies were included if they reported results of an ACE tool being used in a clinical or healthcare setting, participants were aged between 0 and 25 years and the ACE tool was completed by children/young people or by parents/caregivers/clinicians on behalf of the child/young person. Studies assessing clinicians' views on ACE screening in children/young people attending health settings were also included. DATA EXTRACTION AND SYNTHESIS: Two independent reviewers extracted data and assessed for risk of bias using the Mixed Methods Appraisal Tool. Results were synthesised qualitatively. RESULTS: Initial searches identified 5231 articles, of which 36 were included in the final review. Findings showed that the most commonly used tool for assessing ACE was the ACE questionnaire; administering ACE tools was found to be feasible and acceptable; there were limited studies looking at the utility, feasibility and acceptability of assessing for ACE in First Nations people; and while four studies provided information on actions taken following ACE screening, no follow-up data were collected to determine whether participants accessed services and/or the impact of accessing services. CONCLUSION: As the evidence stands, widespread ACE screening is not recommended for routine clinical use. More research is needed on how and what specific ACE to screen for and the impact of screening on well-being. PROSPERO REGISTRATION NUMBER: University of York Centre for Reviews and Dissemination (CRD42021260420).


Asunto(s)
Experiencias Adversas de la Infancia , Adolescente , Adulto , Cuidadores , Niño , Preescolar , Atención a la Salud , Familia , Humanos , Lactante , Recién Nacido , Padres , Adulto Joven
19.
Psychiatry Res ; 316: 114745, 2022 Oct.
Artículo en Inglés | MEDLINE | ID: mdl-35917653

RESUMEN

This cross-sectional multicentre-based study determined the magnitude of relapse, long hospital stay and factors of mental illness associated with a history of childhood trauma. We assessed 335 adult psychiatric patients and living in conflict areas, using a questionnaire established from items of the Adverse Childhood Experience International Questionnaire, Multidimensional Scale of Perceived Social Support, Rosenberg Self-esteem Questionnaire, Relapse Assessment Tool, and Self-report of hospital stay. Logistic regression analyses were used to determine associations between predictors and relapse and long hospital stay. 298 participants (88.9%) had experienced childhood adversities, among which 44.4% reported more than five childhood traumas. Relapse occurred in 40.9% of participants, whereas long hospital stay occurred in 71.1% of cases. Predictors of long hospital stay were emotional abuse, substance use and living in rural settings. Being an employed and experiencing a childhood trauma committed by a parent increase the likelihood risk of relapse of mental illness associated with childhood trauma. Being treated by childhood trauma-focused interventions decreases the risk of relapse and shorter the length of hospital stay. Building a mental health capacity should be centered on detecting patients with childhood trauma committed by the parent, those with low-self esteem, and victims of emotional abuse.


Asunto(s)
Experiencias Adversas de la Infancia , Maltrato a los Niños , Adulto , Niño , Maltrato a los Niños/psicología , Estudios Transversales , Humanos , Tiempo de Internación , Prevalencia , Recurrencia , Factores de Riesgo
20.
J Anxiety Disord ; 91: 102614, 2022 Oct.
Artículo en Inglés | MEDLINE | ID: mdl-35988441

RESUMEN

Hundreds of millions of people suffer anxiety disorders globally, demonstrating need for scalable and effective interventions. Adverse childhood experiences contribute to this mental health burden. The stress-buffering hypothesis, which posits social factors moderate prior adversity and subsequent mental health outcomes, provides one theoretical avenue to consider observations that group-based microfinance programs improve social capital. We investigate associations between adverse childhood experiences, generalized anxiety among adults and social capital associated with participation in a group-based microfinance program in rural Kenya. Adult participants (n = 400 women) responded to standardized measures of childhood adversity in June 2018, group-affiliated social capital and generalized anxiety in June 2019. Cumulative adverse childhood experiences predicted higher anxiety, which was statistically moderated by the presence of group-affiliated interpersonal trust. This study is the first to find social capital associated with participation in a group-based microfinance program statistically moderates expected associations between adverse childhood experiences and adult generalized anxiety. Future study should be conducted using a cluster-randomized control design to further assess the potential of this intervention method to ameliorate associations between past adversity and current mental health.


Asunto(s)
Experiencias Adversas de la Infancia , Capital Social , Adulto , Ansiedad/psicología , Trastornos de Ansiedad , Femenino , Humanos , Kenia
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