The impact of adverse childhood experiences (ACEs) and combat exposure on mental health conditions among new post-9/11 veterans.

2020 ◽  
Vol 12 (7) ◽  
pp. 698-706 ◽  
Author(s):  
Keith R. Aronson ◽  
Daniel F. Perkins ◽  
Nicole R. Morgan ◽  
Julia A. Bleser ◽  
Dawne Vogt ◽  
...  
2021 ◽  
pp. 1-15
Author(s):  
Bridget E. Weller ◽  
Joseph K. Conrad ◽  
Victoria G. Wilburn ◽  
Zo Ramamonjiarivelo ◽  
Jessica Gladden

2020 ◽  
Vol 14 (6) ◽  
pp. 181-197
Author(s):  
Deborah J. Morris ◽  
Elanor Lucy Webb ◽  
Emma Parmar ◽  
Grace Trundle ◽  
Anne McLean

Purpose People with developmental disorders are significantly more likely to experience adverse childhood experiences (ACEs), although the impact of ACEs on this population is not well understood. Furthermore, considerably less is known about the exposure to, and impact of, ACEs in detained adolescents with complex developmental disorder needs. This paper aims to explore the exposure to ACEs in an adolescent population detained in a secure specialist developmental disorder service. Design/methodology/approach A retrospective file review was used to explore ACEs and placement histories within a specialist developmental disorder inpatient service. Data was collated for a convenience sample of 36 adolescents, 9 of whom were female, aged 13–20 years (M = 17.28 years). Findings A total of 33 participants (91.7%) had experienced at least 1 ACE, with 58% experiencing 4 or more ACEs and 36% experiencing 6 or more ACEs. The most common ACEs reported were physical abuse (61.6%), parental separation (58.3%) and emotional abuse (55.6%). The majority of participants had also experienced high levels of disruption prior to admission, with an average of four placement breakdowns (range 1–13, standard deviation = 3.1). ACEs held a significant positive association with the total number of placement breakdowns and total number of mental health diagnoses. Practical implications Adolescents detained in specialist developmental disorder secure care had, at the point of admission, experienced high levels of adversities and had been exposed to high levels of experienced and observed abuse. The level of exposure to adversity and ongoing disruptions in care suggests that Child and Adolescent Mental Health Services’ developmental secure services should consider adopting dual treatment frameworks of developmental disorder and trauma-informed care. Originality/value This study explored the early-life and placement experiences of a marginalised and understudied population.


2021 ◽  
Vol 12 ◽  
Author(s):  
Márcia Novais ◽  
Teresa Henriques ◽  
Maria João Vidal-Alves ◽  
Teresa Magalhães

Introduction: Previous studies have shown that adverse childhood experiences negatively impact child development, with consequences throughout the lifespan. Some of these consequences include the exacerbation or onset of several pathologies and risk behaviors.Materials and Methods: A convenience sample of 398 individuals aged 20 years or older from the Porto metropolitan area, with quotas, was collected. The evaluation was conducted using an anonymous questionnaire that included sociodemographic questions about exposure to adverse childhood experiences, a list of current health conditions, questions about risk behaviors, the AUDIT-C test, the Fagerström test and the Childhood Trauma Questionnaire–brief form. Variables were quantified to measure adverse childhood experiences, pathologies, and risk behaviors in adult individuals for comparison purposes.Results: Individuals with different forms of adverse childhood experiences present higher rates of smoking dependence, self-harm behaviors, victimization of/aggression toward intimate partners, early onset of sexual life, sexually transmitted infections, multiple sexual partners, abortions, anxiety, depression, diabetes, arthritis, high cholesterol, hypertension, and stroke. Different associations are analyzed and presented.Discussion and Conclusions: The results show that individuals with adverse childhood experiences have higher total scores for more risk behaviors and health conditions than individuals without traumatic backgrounds. These results are relevant for health purposes and indicate the need for further research to promote preventive and protective measures.


2021 ◽  
Vol 2 (1) ◽  
Author(s):  
Monica Perez Jolles ◽  
Wendy J. Mack ◽  
Christina Reaves ◽  
Lisa Saldana ◽  
Nicole A. Stadnick ◽  
...  

Abstract Background Adverse childhood experiences (ACEs) are potentially traumatic events occurring before age 18, such as maltreatment or exposure to violence. ACE screening is increasingly recommended to prevent and address physical and mental health conditions associated with ACEs. To promote ACE screening uptake, the state of California issued the “ACEs Aware” policy that provides Medicaid reimbursement for ACE screening annually for child primary care visits. However, policy directives alone often do not translate into effective screening efforts and greater access to care. Few rigorous studies have developed and tested implementation strategies for ACE pediatric screening policies. This study will fill this gap by testing a multifaceted implementation strategy in partnership with a Federally Qualified Health Center (FQHC) system serving low-income families in Southern California to support the ACE Aware policy. Methods We will use Implementation Mapping, with study process and consideration of determinants and mechanisms guided by the EPIS framework, to co-create and refine an implementation strategy. The proposed strategy is comprised of online training videos, a customized algorithm and use of technology to improve workflow efficiency, implementation training to internal FQHC personnel, clinic support and coaching, and written implementation protocols. A hybrid type 2, stepped-wedge cluster randomized trial design with five primary care clinics will test whether a multifaceted implementation strategy improves (a) fidelity to the ACE screening protocol, (b) reach defined as the proportion of eligible children screened for ACEs, and (c) the impact of the ACE policy on child-level mental health referrals and symptom outcomes. The study will use mixed methods with data to include electronic health records, surveys, and interviews with clinic personnel and caregivers. Discussion This study is designed to increase the capacity of FQHCs’ inner context to successfully implement an outer context-initiated ACE policy designed to benefit pediatric patients. It capitalizes on a rare opportunity to use a co-creation approach to develop, adapt, refine, and pilot test an implementation strategy to maximize the impact of a new state-wide policy intended to improve ACE assessment and subsequent care to improve child health, particularly those from underserved communities. Trial registration Trial # NCT04916587 registered at ClinicalTrials.gov on June 4, 2021.


2021 ◽  
Author(s):  
Naira Ikram ◽  
Allison Frost ◽  
Katherine LeMasters ◽  
Ashley Hagaman ◽  
Victoria Baranov ◽  
...  

Abstract Background: Adverse Childhood Experiences (ACEs) are linked to poor maternal mental health. By disrupting stress regulation systems, ACEs are hypothesized to impact perceived stress, anxiety, and cortisol. This study explores the associations of ACEs with different manifestations of stress. Methods: Participants were part of the Bachpan study, a longitudinal birth cohort in rural Pakistan. Data were collected at the 36-month postpartum wave. ACEs were captured retrospectively using an adapted version of the ACE International Questionaire, and represented in the following ways: as a continuous variable, binary indicator, categoric levels, and subdomains (neglect, home violence, family psychological distress, community violence). Outcomes included: perceived stress (N=889) measured with the Cohen Perceived Stress Scale (PSS), anxiety (N=623) measured with the Generalized Anixety Disorder-7 scale (GAD-7), and hair-derived cortisol (N=90). Multivariable linear mixed models estimated associations between ACEs and the outcome variables. Results: All models featured positive associations between ACE items and PSS. Both the continuous total ACE score (B=0.4; 95% CI=0.0, 0.8) and the presence of any ACEs (B=1.0; 95% CI=-1.0, 0.3) were associated with higher anxiety symptoms on the GAD-7. Home violence (B=6.7; 95% CI=2.7, 10.8) and community violence (B=7.5; 95% CI=1.4,13.6) were associated with increased hair cortisol. Conclusions: All four ACE domains were associated with elevated levels of perceived stress, anxiety, and cortisol, with varying precision and strength of estimates, indicating that the type of ACE has a differential impact. This study disentangled adversity to understand the impact of specific adverse events on hypothalamic pituitary adrenal (HPA) axis functioning and mental health conditions.


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