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Adverse Childhood Experience

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Robert F Anda – One of the best experts on this subject based on the ideXlab platform.

  • Adverse Childhood Experiences and smoking status in five states
    Preventive Medicine, 2011
    Co-Authors: Earl S Ford, Robert F Anda, Valerie J Edwards, Geraldine S Perry, Guixiang Zhao, Chaoyang Li, Janet B Croft
    Abstract:

    Abstract Objective Our objective was to examine the associations between Adverse Childhood Experiences (ACEs) and smoking behavior among a random sample of adults living in five U.S. states. Methods We used data from 25,809 participants of the 2009 Behavioral Risk Factor Surveillance System to assess the relationship of each of the 8 Adverse Childhood Experiences and the Adverse Childhood Experience score to smoking status. Results and conclusions Some 59.4% of men and women reported at least one Adverse Childhood Experience. Each of the eight Adverse Childhood Experiences measures was significantly associated with smoking status after adjustment for demographic variables. The prevalence ratios for current and ever smoking increased in a positive graded fashion as the Adverse Childhood Experience score increased. Among adults who reported no Adverse Childhood Experiences, 13.0% were currently smoking and 38.3% had ever smoked. Compared to participants with an Adverse Childhood Experience score of 0, those with an Adverse Childhood Experience score of 5 or more were more likely to be a current smoker (adjusted prevalence ratio (aPR): 2.22, 95% confidence interval [CI]: 1.92–2.57) and to have ever smoked (aPR: 1.80, 95% CI: 1.67–1.93). Further research is warranted to determine whether the prevention of and interventions for Adverse Childhood Experiences might reduce the burden of smoking-related illness in the general population.

  • Adverse Childhood Experiences and risk of paternity in teen pregnancy
    Obstetrics & Gynecology, 2002
    Co-Authors: Robert F Anda, Daniel P Chapman, Vincent J Felitti, Valerie J Edwards, David F Williamson, Janet B Croft, Wayne H Giles
    Abstract:

    OBJECTIVE: Few studies have investigated risk factors that predispose males to be involved in teen pregnancies. To provide new information on such factors, we examined the relationships of eight common Adverse Childhood Experiences to a male’s risk of impregnating a teenager. METHODS: We conducted a retrospective cohort study using questionnaire responses from 7399 men who visited a primary care clinic of a large health maintenance organization in California. Data included age of the youngest female ever impregnated; the man’s own age at the time; his history of Childhood emotional, physical, or sexual abuse; having a battered mother; parental separation or divorce; and having household members who were substance abusers, mentally ill, or criminals. Odds ratios (ORs) for the risk of involvement in a teen pregnancy were adjusted for age, race, and education. RESULTS: At least one Adverse Childhood Experience was reported by 63% of participants, and 34% had at least two Adverse Childhood Experiences; 19% of men had been involved in a teen pregnancy. Each Adverse Childhood Experience was positively associated with impregnating a teenager, with ORs ranging from 1.2 (sexual abuse) to 1.8 (criminal in home). We found strong graded relationships (P < .001) between the number of Adverse Childhood Experiences and the risk of involvement in a teen pregnancy for each of four birth cohorts during the last century. Compared with males with no Adverse Childhood Experiences, a male with at least five Adverse Childhood Experiences had an OR of 2.6 (95% confidence interval [CI] 2.0, 3.4) for impregnating a teenager. The magnitude of the ORs for the Adverse Childhood Experiences was reduced 64 ‐100% by adjustment for potential intermediate variables (age at first intercourse, number of sexual partners, having a sexually transmitted disease, and alcohol or drug abuse) that also exhibited a strong graded relationship to Adverse Childhood Experiences. CONCLUSION: Adverse Childhood Experiences have an important relationship to male involvement in teen pregnancy. This relationship has persisted throughout four successive birth cohorts dating back to 1900 ‐1929, suggesting that the effects of Adverse Childhood Experiences transcend changing sexual mores and contraceptive methods. Efforts to prevent teen pregnancy will likely benefit from preventing Adverse Childhood Experiences and their associated effects on male behaviors that might mediate the increased risk of teen pregnancy. (Obstet Gynecol 2002; 100:37‐ 45. © 2002 by The American College of Obstetricians and Gynecologists.)

  • Childhood abuse household dysfunction and the risk of attempted suicide throughout the life span findings from the Adverse Childhood Experiences study
    JAMA, 2001
    Co-Authors: Shanta R Dube, Robert F Anda, Daniel P Chapman, Vincent J Felitti, David F Williamson, Wayne H Giles
    Abstract:

    ContextSuicide is a leading cause of death in the United States, but identifying persons at risk is difficult. Thus, the US surgeon general has made suicide prevention a national priority. An expanding body of research suggests that Childhood trauma and Adverse Experiences can lead to a variety of negative health outcomes, including attempted suicide among adolescents and adults.ObjectiveTo examine the relationship between the risk of suicide attempts and Adverse Childhood Experiences and the number of such Experiences (Adverse Childhood Experiences [ACE] score).Design, Setting, and ParticipantsA retrospective cohort study of 17 337 adult health maintenance organization members (54% female; mean [SD] age, 57 [15.3] years) who attended a primary care clinic in San Diego, Calif, within a 3-year period (1995-1997) and completed a survey about Childhood abuse and household dysfunction, suicide attempts (including age at first attempt), and multiple other health-related issues.Main Outcome MeasureSelf-reported suicide attempts, compared by number of Adverse Childhood Experiences, including emotional, physical, and sexual abuse; household substance abuse, mental illness, and incarceration; and parental domestic violence, separation, or divorce.ResultsThe lifetime prevalence of having at least 1 suicide attempt was 3.8%. Adverse Childhood Experiences in any category increased the risk of attempted suicide 2- to 5-fold. The ACE score had a strong, graded relationship to attempted suicide during Childhood/adolescence and adulthood (P<.001). Compared with persons with no such Experiences (prevalence of attempted suicide, 1.1%), the adjusted odds ratio of ever attempting suicide among persons with 7 or more Experiences (35.2%) was 31.1 (95% confidence interval, 20.6-47.1). Adjustment for illicit drug use, depressed affect, and self-reported alcoholism reduced the strength of the relationship between the ACE score and suicide attempts, suggesting partial mediation of the Adverse Childhood Experience–suicide attempt relationship by these factors. The population-attributable risk fractions for 1 or more Experiences were 67%, 64%, and 80% for lifetime, adult, and Childhood/adolescent suicide attempts, respectively.ConclusionsA powerful graded relationship exists between Adverse Childhood Experiences and risk of attempted suicide throughout the life span. Alcoholism, depressed affect, and illicit drug use, which are strongly associated with such Experiences, appear to partially mediate this relationship. Because estimates of the attributable risk fraction caused by these Experiences were large, prevention of these Experiences and the treatment of persons affected by them may lead to progress in suicide prevention.

Janet B Croft – One of the best experts on this subject based on the ideXlab platform.

  • Adverse Childhood Experiences and smoking status in five states
    Preventive Medicine, 2011
    Co-Authors: Earl S Ford, Robert F Anda, Valerie J Edwards, Geraldine S Perry, Guixiang Zhao, Chaoyang Li, Janet B Croft
    Abstract:

    Abstract Objective Our objective was to examine the associations between Adverse Childhood Experiences (ACEs) and smoking behavior among a random sample of adults living in five U.S. states. Methods We used data from 25,809 participants of the 2009 Behavioral Risk Factor Surveillance System to assess the relationship of each of the 8 Adverse Childhood Experiences and the Adverse Childhood Experience score to smoking status. Results and conclusions Some 59.4% of men and women reported at least one Adverse Childhood Experience. Each of the eight Adverse Childhood Experiences measures was significantly associated with smoking status after adjustment for demographic variables. The prevalence ratios for current and ever smoking increased in a positive graded fashion as the Adverse Childhood Experience score increased. Among adults who reported no Adverse Childhood Experiences, 13.0% were currently smoking and 38.3% had ever smoked. Compared to participants with an Adverse Childhood Experience score of 0, those with an Adverse Childhood Experience score of 5 or more were more likely to be a current smoker (adjusted prevalence ratio (aPR): 2.22, 95% confidence interval [CI]: 1.92–2.57) and to have ever smoked (aPR: 1.80, 95% CI: 1.67–1.93). Further research is warranted to determine whether the prevention of and interventions for Adverse Childhood Experiences might reduce the burden of smoking-related illness in the general population.

  • Adverse Childhood Experiences and risk of paternity in teen pregnancy
    Obstetrics & Gynecology, 2002
    Co-Authors: Robert F Anda, Daniel P Chapman, Vincent J Felitti, Valerie J Edwards, David F Williamson, Janet B Croft, Wayne H Giles
    Abstract:

    OBJECTIVE: Few studies have investigated risk factors that predispose males to be involved in teen pregnancies. To provide new information on such factors, we examined the relationships of eight common Adverse Childhood Experiences to a male’s risk of impregnating a teenager. METHODS: We conducted a retrospective cohort study using questionnaire responses from 7399 men who visited a primary care clinic of a large health maintenance organization in California. Data included age of the youngest female ever impregnated; the man’s own age at the time; his history of Childhood emotional, physical, or sexual abuse; having a battered mother; parental separation or divorce; and having household members who were substance abusers, mentally ill, or criminals. Odds ratios (ORs) for the risk of involvement in a teen pregnancy were adjusted for age, race, and education. RESULTS: At least one Adverse Childhood Experience was reported by 63% of participants, and 34% had at least two Adverse Childhood Experiences; 19% of men had been involved in a teen pregnancy. Each Adverse Childhood Experience was positively associated with impregnating a teenager, with ORs ranging from 1.2 (sexual abuse) to 1.8 (criminal in home). We found strong graded relationships (P < .001) between the number of Adverse Childhood Experiences and the risk of involvement in a teen pregnancy for each of four birth cohorts during the last century. Compared with males with no Adverse Childhood Experiences, a male with at least five Adverse Childhood Experiences had an OR of 2.6 (95% confidence interval [CI] 2.0, 3.4) for impregnating a teenager. The magnitude of the ORs for the Adverse Childhood Experiences was reduced 64 ‐100% by adjustment for potential intermediate variables (age at first intercourse, number of sexual partners, having a sexually transmitted disease, and alcohol or drug abuse) that also exhibited a strong graded relationship to Adverse Childhood Experiences. CONCLUSION: Adverse Childhood Experiences have an important relationship to male involvement in teen pregnancy. This relationship has persisted throughout four successive birth cohorts dating back to 1900 ‐1929, suggesting that the effects of Adverse Childhood Experiences transcend changing sexual mores and contraceptive methods. Efforts to prevent teen pregnancy will likely benefit from preventing Adverse Childhood Experiences and their associated effects on male behaviors that might mediate the increased risk of teen pregnancy. (Obstet Gynecol 2002; 100:37‐ 45. © 2002 by The American College of Obstetricians and Gynecologists.)

Helen Minnis – One of the best experts on this subject based on the ideXlab platform.

  • practitioner review twenty years of research with Adverse Childhood Experience scores advantages disadvantages and applications to practice
    Journal of Child Psychology and Psychiatry, 2020
    Co-Authors: Rebecca E Lacey, Helen Minnis
    Abstract:

    Background: Adverse Childhood Experience (ACE) scores have become a common approach for considering Childhood adversities and are highly influential in public policy and clinical practice. Their use is also controversial. Other ways of measuring adversity ‐ examining single adversities, or using theoretically or empirically driven methods ‐ might have advantages over ACE scores. Methods: In this narrative review we critique the conceptualisation and measurement of ACEs in research, clinical practice, public health and public discourse. Results: The ACE score approach has the advantages – and limitations – of simplicity: its simplicity facilitates wide‐ranging applications in public policy, public health and clinical settings but risks over‐simplistic communication of risk/causality, determinism and stigma. The other common approach – focussing on single adversities ‐ is also limited because adversities tend to co‐occur. Researchers are using rapidly accruing datasets on ACEs to facilitate new theoretical and empirical approaches but this work is at an early stage, e.g. weighting ACEs and including severity, frequency, duration and timing. More research is needed to establish what should be included as an ACE, how individual ACEs should be weighted, how ACEs cluster, and the implications of these findings for clinical work and policy. New ways of conceptualising and measuring ACEs that incorporate this new knowledge, while maintaining some of the simplicity of the current ACE questionnaire, could be helpful for clinicians, practitioners, patients and the public. Conclusions: Although we welcome the current focus on ACEs, a more critical view of their conceptualisation, measurement, and application to practice settings is urgently needed.

Andre Bussieres – One of the best experts on this subject based on the ideXlab platform.

  • Adverse Childhood Experience and adult persistent pain and disability protocol for a systematic review and meta analysis
    Systematic Reviews, 2020
    Co-Authors: Andre Bussieres, Jan Hartvigsen, Manuela L Ferreira, Paulo H Ferreira, Mark J Hancock, Laura S Stone, Timothy H Wideman, Jill Boruff, Ask Elklit
    Abstract:

    A growing body of research highlights the pervasive harms of Adverse Childhood Experiences (ACEs) on health throughout the life-course. However, findings from prior reviews and recent longitudinal studies investigating the association between types of ACEs and persistent pain have yielded inconsistent findings in the strength and direction of associations. The purpose of this review is to appraise and summarize evidence on the relationship between ACEs and persistent pain and disability outcomes in adulthood. The specific aims are (1) to determine whether there is a relationship between exposure to ACE and persistent pain and disability in adults and (2) to determine whether unique and cumulative ACEs exposures (number and type) increase the risk of developing persistent pain and disability in adulthood. A systematic review and meta-analysis of observational studies will be conducted. Our eligibility criteria are defined following a PECOS approach: population, adults with persistent (≥ 3 months) musculoskeletal and somatoform painful disorders exposed to single or cumulative direct ACEs alone (i.e., physical, sexual, emotional abuse or neglect) or in combination to indirect types of ACE (e.g., parental death, exposure to domestic violence) in the first 18 years of life; comparators, unexposed individuals; outcomes, measurements for persistent pain (≥ 3 months) and disability using discrete and/or continuous measures; and settings, general population, primary care. A comprehensive search of MEDLINE (Ovid) and nine other pertinent databases was conducted from inception to 29 August 2019 using a combination of key words and MeSh terms (the search will be updated prior to conducting the analyses). Pairs of reviewers will independently screen records and full text articles, and a third reviewer will be consulted in cases of disagreement. Data will be extracted using Endnote and Covidence and a meta-analysis will be conducted using Review Manager (RevMan) Version 5.3. The Scottish Intercollegiate Guidelines Network (SIGN) and the Joanna Briggs Institute (JBI) checklists will be used to assess the quality of the included studies. If heterogeneity is high, the findings will be presented in narrative form. The present review will help consolidate knowledge on persistent pain and disability by evaluating whether frequency and type of Adverse Childhood Experiences produces the most harm. Findings may help inform practitioners and policy-makers who endeavor to prevent and/or mitigate the consequences of ACEs and promote healthy development and well-being of children, youth, and families. PROSPERO CRD42020150230

Shawna J Lee – One of the best experts on this subject based on the ideXlab platform.

  • spanking and adult mental health impairment the case for the designation of spanking as an Adverse Childhood Experience
    Child Abuse & Neglect, 2017
    Co-Authors: Tracie O Afifi, Derek C Ford, Elizabeth T Gershoff, Melissa T Merrick, Andrew Grogankaylor, Katie A Ports, Harriet L Macmillan, George W Holden, Catherine A Taylor, Shawna J Lee
    Abstract:

    Adverse Childhood Experiences (ACEs) such as child abuse are related to poor health outcomes. Spanking has indicated a similar association with health outcomes, but to date has not been considered an ACE. Physical and emotional abuse have been shown in previous research to correlate highly and may be similar in nature to spanking. To determine if spanking should be considered an ACE, this study aimed to examine 1): the grouping of spanking with physical and emotional abuse; and 2) if spanking has similar associations with poor adult health problems and accounts for additional model variance. Adult mental health problems included depressive affect, suicide attempts, moderate to heavy drinking, and street drug use. Data were from the CDC-Kaiser ACE study (N=8316, response rate=65%). Spanking loaded on the same factor as the physical and emotional abuse items. Additionally, spanking was associated with increased odds of suicide attempts (Adjusted Odds Ratios (AOR)=1.37; 95% CI=1.02 to1.86), moderate to heavy drinking (AOR)=1.23; 95% CI=1.07 to 1.41), and the use of street drugs (AOR)=1.32; 95% CI=1.4 to 1.52) in adulthood over and above experiencing physical and emotional abuse. This indicates spanking accounts for additional model variance and improves our understanding of these outcomes. Thus, spanking is empirically similar to physical and emotional abuse and including spanking with abuse adds to our understanding of these mental health problems. Spanking should also be considered an ACE and addressed in efforts to prevent violence.