[Editor's note: Dr. Harise Stein at Stanford University edits a web site — abuseresearch.info — that focuses on the effects of abuse, and includes research articles on PACEs. Every month, she posts the summaries of the abstracts and links to research articles that address only ACEs, PCEs and PACEs. Thank you, Harise!! — Rafael Maravilla]
LGBTQ Concerns
Arayasirikul S, Turner CM, Hernandez CJ, et al.
Transphobic Adverse Childhood Experiences as a Determinant of Mental and Sexual Health for Young Trans Women in the San Francisco Bay Area. Transgend Health. 2022;7(6):552-5. PMID: 36518300
“A survey was administered between 2012 and 2014 to 300 YTW [young trans women] aged 16-24 living in the San Francisco Bay Area. Our study showed that YTW were highly impacted by ACEs during their childhood, including physical and verbal transphobic abuse. The ACE measurements in our study correlated to a host of mental health conditions and unsafe sexual practices. There is a need to understand how ACEs specifically impact trans women separately from other sexual and gender minorities…to help address the factors that lead YTW to be disproportionately affected by substance use, mental health conditions, homelessness, and HIV.
Race/Cultural Concerns
Jegarl AM, Jegede O, Isom J, Ciarleglio N, Black C.
Psychotic Misdiagnosis of Racially Minoritized Patients: A Case-Based Ethics, Equity, and Educational Exploration. Harv Rev Psychiatry. 2023 Jan-Feb 01;31(1):28-36. PMID: 36608081
“Evidence suggests that providers assign a diagnosis of schizophrenia and/or schizoaffective disorder according to race more than any other demographic variable, and this inequity persists even in the absence of differences in clinician symptom ratings.” A case report is presented of a young Black woman who was re-diagnosed with major depression and PTSD, and “expert discussion is provided by three Black academic psychiatrists with expertise in social justice and health equity.”
van Daalen KR, Kaiser J, Kebede S, et. al.
Racial discrimination and adverse pregnancy outcomes: a systematic review and meta-analysis. BMJ Glob Health. 2022 Aug;7(8):e009227. PMID: 35918071
From a research review, across all outcomes, significant positive associations were found between experiencing racial discrimination and an adverse pregnancy event, including premature birth and low birth weight.
Karvonen KL, McKenzie-Sampson S, Baer RJ, et al.
Structural racism is associated with adverse postnatal outcomes among Black preterm infants. Pediatr Res. 2022:1-7. PMID: 36577795
From a study of Black birthing people in California 2011-2017, “Black birthing people who delivered preterm in the least privileged tertiles were more likely to have infants who experienced frequent acute care visits (crude risk ratio [cRR] 1.3), readmissions (cRR 1.1), and post-discharge death (cRR 1.9) in their first year compared to those in the privileged tertile. Results did not differ significantly after adjusting for infant or birthing person characteristics.”
Schouler-Ocak M, Moran JK.
Racial discrimination and its impact on mental health. Int Rev Psychiatry. 2022:1-9. PMID: 36519290
“There is evidence that racial discrimination at different levels has a major impact on mental health over the whole life span…All forms of structural, institutionalised, interpersonal and internalised racism as well as the cumulative impact of intersectional discrimination appear to be linked to mental health and well-being.”
Johnson ME, Rigg KK, Vroom EB, Akbari Z, Bristol SC. Racial/Ethnic Differences in the Effects of Adverse Childhood Experiences on Substance Misuse among Justice-Involved Children. Subst Use Misuse. 2022:1-12. PMID: 36469650
From a Florida statewide dataset of 79,960 justice-involved children (JIC), “higher ACE scores were linked to substance use and substance use disorder. Black JIC were 2.46 times more likely, and Latinx JIC were 1.40 times more likely to report substance use than white JIC.”
Hughes AJ, Gunn H, Siengsukon C, et al.
Eliminating Sleep Health Disparities and Achieving Health Equity: Seven Areas for Action in the Behavioral Sleep Medicine Community. Behav Sleep Med. 2022:1-13. PMID: 36573844
“Research exploring disparities have documented a plethora of factors including social determinants of health, community violence, and structural issues - all of which are associated with adverse sleep. There are robust evidence base of behavioral interventions that can be leveraged to improve sleep health among racial and ethnic groups.” This report was created by members of the society of behavioral sleep medicine to discuss gaps and opportunities, and make recommendations, at the intersection of the COVID-19 pandemic, systemic racism, and sleep health.
Thomas MMC, Waldfogel J, Williams OF.
Inequities in Child Protective Services Contact Between Black and White Children. Child Maltreat. 2023;28(1):42-54. Epub 20220202. PMID: 35081781
Using data from the Fragile Families and Child Wellbeing Study, “Income poverty was a significant predictor of CPS contact among White families, who were protected by higher income. In contrast, income per se was not a significant predictor of CPS contact among Black families, who were instead impacted by racialized family regulation and consequences of poverty, such as poor health and depression…Implications include centering systemic racism and specifically racialized poverty as causes of racial inequities in CPS contact, and rethinking the role of CPS in protecting children.”
Perpetrators
St-Pierre Bouchard J, Brassard A, Lefebvre AA, et al.
Cumulative Childhood Trauma, Communication Patterns, and IPV Perpetrated by Men Seeking Help. J Interpers Violence. 2022:8862605221138651. PMID: 36452964
Of 577 men seeking help from community centers specializing in IPV, having sustained a higher number of different forms of childhood trauma is directly related to men's higher risk of perpetrating psychological IPV. Cumulative childhood trauma is also indirectly related to higher perpetrated psychological and physical IPV and coercive control through more dysfunctional communication patterns. Authors note the importance of assessing in therapy ACEs as well as communication patterns.
Belfry KD, Ham E, Kolla NJ, Hilton NZ.
Adverse Childhood Experiences and Offending as a Function of Acquired Brain Injury Among Men in a High Secure Forensic Psychiatric Hospital. Can J Psychiatry. 2022:7067437221144629. PMID: 36537143
Of 637 Canadian adult males admitted to a high secure forensic hospital, one-fifth had a documented acquired brain injury (ABI) indicator. “ABI was more likely to be identified by greater adverse childhood experiences (ACEs), more health problems in childhood, and lower socioeconomic status, suggesting that ABI within the forensic context is associated with greater developmental disadvantage. Men with ABI had more serious pre-admission offences, but not more serious admission offences or in-hospital aggression. Men with ABI were more likely than those without…to be diagnosed with mood and personality disorders, and less likely to have a schizophrenia diagnosis.”
Jeglic EL, Winters GM, Johnson BN.
Identification of red flag child sexual grooming behaviors. Child Abuse Negl. 2022;136:105998. PMID: 36577252
From an online survey of adults who had experienced childhood sexual abuse and those who did not but were asked about a relationship with an older male during their childhood, the most important red flag grooming behaviors that distinguished the two groups, and which may play a role in prevention, were behaviors specifically related to desensitizing the child to physical contact and to sexual content.
Providers
Negriff S, DiGangi MJ, Sidell M, Liu J, Coleman KJ.
Assessment of Screening for Adverse Childhood Experiences and Receipt of Behavioral Health Services Among Children and Adolescents. JAMA network open. 2022;5(12):e2247421. PMID: 36534401
A clinic within a large health care system instituted pilot child and adolescent ACE screening. For those with an ACE score of 1 or more, an intervention was implemented that included additional screening questions and incorporated social workers into the process of evaluation and referral for behavioral health needs…After the intervention, children were more likely to have a behavioral health services visit within 90 days of the screening than before the intervention (from 4.33% to 32.48%; incidence rate ratio, 7.50).
Long D, Hessler D, Koita K, et al.
Screening for adverse childhood experiences in pediatrics: A randomized trial of aggregate-level versus item-level response screening formats. PLoS One. 2022;17(12):e0273491. PMID: 36520927
In a medical setting, 367 child caregivers were given a Pediatric ACEs and Related Life Events Screener (PEARLS) tool, either with line-item response or aggregate response. In a debriefing afterwards, caregivers reported preference for the line-item response, however disclosure rates were significantly higher for aggregate response. Other caregiver comments related to provider relationship, fear with disclosure, and screening outcome expectations.
English A, McKibben E, Sivaramakrishnan D, et al.
A Rapid Review Exploring the Role of Yoga in Healing Psychological Trauma. Int J Environ Res Public Health. 2022;19(23). PMID: 36498254
From a research review, “The following main impacts of yoga on participants were identified: feeling an increased sense of self-compassion; feeling more centered; developing their coping skills; having a better mind-body relationship; and improving their relationships with others. The main barriers were: concerns initiating yoga; time and motivational issues; and the costs and location of classes. The main facilitator was the feeling of safety generated in the trauma-informed yoga classes…yoga offers great potential in the field of trauma recovery. Research is called for to allow this field to advance.”
Bhui K, Shakoor S, Mankee-Williams A, Otis M.
Creative arts and digital interventions as potential tools in prevention and recovery from the mental health consequences of adverse childhood experiences. Nature communications. 2022;13(1):7870. PMID: 36550111
“Creative arts such as music, dance, drama and visual arts, and arts-based therapies are emerging as important approaches in the treatment of childhood trauma. Arts based research and interventions permit gradual exploration of adverse experiences, where the creator exercises control over disclosure, and non-verbal disclosure or awareness grows, leading an ethical and safer process that is less likely to lead to distress or trigger traumatic symptoms. Evidence suggests that arts-based interventions improve sense of achievement, self-confidence, self-esteem, social skills, conflict resolution, problem solving, relationships, and sense of belonging amongst adolescents. Equally, these activities have been successful in improving mental health.”
Prevention
Michaelson V, Ensom R.
Ending the Social Normalization of Violence against Children in Canada: A Framework, Rationale, and Appeal to Canadian Faith Leaders. Int J Environ Res Public Health. 2022;19(24). PMID: 36554899
“Corporal punishment remains the most common form of violence against children in Canada. Along with being legally permitted, it is made socially acceptable through cultural and social norms often disguised as discipline…In this commentary, we outline the ways that Christian religion has contributed to social norms around corporal punishment. We then argue that religious leaders have an opportunity-and moral responsibility-to contribute to change. We conclude with insights from social norms theory and offer evidence-based recommendations for ways forward that could help shift attitudes around corporal punishment in order to decrease its prevalence and harm.”
Buchanan GJR, Tate AD, Barnes A, Trofholz AC, Berge JM.
Potential Points of Intervention to Minimize the Impact of Parents' Adverse Childhood Experiences on Child Mental Health. J Dev Behav Pediatr. 2023;44(1):e24-e31. PMID: 36563343
“Parents with high ACEs but who have good mental health [MH] and positive parenting behaviors demonstrated no impact of their ACEs on their children's mental health. Providing MH care to parents and parenting programs may be strategies for improving children's MH. Parenting behavior assessment is recommended for clinicians when pediatric patients present with MH concerns.”
Researchers
Grilo SA, Santelli JS, Nathanson CA, et. al.
Social and Structural Influences on Multiracial Identification and Health: a Public Health Mandate to Precisely Measure, Theorize, and Better Understand Multiracial Populations. J Racial Ethn Health Disparities. 2023 Feb;10(1):427-445. PMID: 35192180
“There is a growing group of adolescents and young adults in the USA who identify as multiracial. However, very little research, especially health research, focuses on understanding multiracial identification and health and behavioral outcomes for multiracial populations in comparison to their single-race counterparts. Understanding the intersectional influences on this identification process is critical…on understanding the impact of structural racism and discrimination.”
Wu Y, Goodman GS, Goldfarb D, et al.
Memory Accuracy After 20 Years for Interviews About Child Maltreatment. Child Maltreat. 2023;28(1):85-96. PMID: 34879739
“In this longitudinal study, 104 adults, who as children (ages 3-15 years) were interviewed in child maltreatment investigations (Time 1), were questioned 20 years later (Time 2) about the Time 1 interviews…36% reported no memory for the Time 1 interviews. Of the 64% who remembered being interviewed at Time 1, those who had been adolescents at Time 1 remembered the forensic interview discussion about abuse incidents better than discussion about general psychological issues…Findings indicate that the veracity of adults' long-term memory for clinical/forensic conversations about childhood maltreatment depends on age at interview, interview content, and traumatization factors. Implications are discussed.”
Soneson E, Das S, Burn AM, et al.
Leveraging Administrative Data to Better Understand and Address Child Maltreatment: A Scoping Review of Data Linkage Studies.
Child Maltreat. 2023;28(1):176-95. PMID: 35240863
Authors review studies that contain various types of data linkages. “However, how research using linked data can be translated into effective service development and monitoring, or targeting of interventions, is underexplored in terms of privacy protection, ethics and governance, data quality, and evidence of effectiveness.”
Backhaus S, Leijten P, Meinck F, Gardner F.
Different Instruments, Same Content? A Systematic Comparison of Child Maltreatment and Harsh Parenting Instruments. Trauma Violence Abuse. 2022:15248380221134290. PMID: 36437787
Authors compare 7 parent-reported child maltreatment and 18 harsh parenting instruments. Both types measured similar emotional behaviors and physical behaviors, however the maltreatment instruments also included twisting body parts and choking. “Our findings can help guide discussions on definitions, operationalizations, and their consequences for research on violence against children.”
Woods-Jaeger B, Kleven L, et. al.
Two generations thrive: Bidirectional collaboration among researchers, practitioners, and parents to promote culturally responsive trauma research, practice, and policy. Psychol Trauma. 2023 Feb;15(2):181-188. PMID: 35604710
“This paper describes a collaboration among researchers, practitioners, and parents of color with lived experiences of ACEs entitled: Two Generations Thrive, which aims to prevent the intergenerational transmission of ACEs through improving practices and policies within the health care, education, and child welfare systems…Key lessons learned include: the importance of building and maintaining trust, consistently working to mitigate power imbalances, and the power of bidirectional collaboration to maximize the benefit of research and action for communities traditionally marginalized in research and practice.”
Other of Interest
Peña PA, Jena A.
Child Deaths by Gun Violence in the US During the COVID-19 Pandemic. JAMA Netw Open. 2022 Aug 1;5(8):e2225339. PMID: 35925607
Using data from the Gun Violence Archive (GVA), a repository of gun violence collected from more than 7500 law enforcement, media, government, and commercial sources, from January 2014 to December 2022, “Overall, 8044 shootings were analyzed and involved 8477 children killed. Of these 8477 children, 22.3% were aged 0 to 11 years and 77.7% were 12 to 17 years; 19.6% were girls, 78.8% were boys, and 1.7% had unknown gender. 58.0% were from a high-minority area (defined as having more than 50% Black or Hispanic population). An increase in deaths was observed from March 16, 2020 onwards.
Skiendzielewski K, Forke CM, Sarwer DB, et al.
The intersection of adverse childhood experiences and neighborhood determinants of health: An exploratory spatial analysis. Psychol Trauma. 2022 Jul 14:10.1037/tra0001320. PMID: 35834220
From a survey of 1679 Philadelphia adults, and linking other data spatially, “Individuals with ≥ 4 ACEs lived in neighborhoods with higher neighborhood poverty rates, less socioeconomic resources, worse food access, poorer perceived physical and mental health, more substance overdose deaths, higher crime, and less green space…Findings suggest future work may benefit from considering neighborhood environments when examining and intervening upon the association between ACEs and poor physical and psychological health.”
Raja US, Carrico AR.
Childhood trauma and other formative life experiences predict environmental engagement. Scientific reports. 2022;12(1):20756. PMID: 36456711
“In this paper, we focus on childhood formative experiences and the extent to which they are correlated with environmental engagement. We consider two forms of environmental engagement: civic engagement, measured in hours per month devoted to an environmental protection cause, and private-sphere green behavior…Looking at a nationally representative sample of American adults (n = 449), we find that childhood trauma predicts both civic engagement and green behavior, while childhood experiences in nature and childhood travel experiences predict green behavior but not civic engagement.” Authors note prior studies showing that trauma and maltreatment may result for some in increased empathy, leading to “participants said they felt empathy toward the environment, which was also suffering”, “are attempting to find meaning in something larger”, and “traumatic events cause people to become more emotionally aware and attuned to cues that signal distress”. “The finding that childhood trauma has an even stronger relationship with environmental engagement is more novel and somewhat surprising. Given the large literature suggesting that childhood trauma sometimes undermines pro-social behavior towards other humans, these data indicate the need for further research.”
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