[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]
Elder Abuse
Williams B.
Understanding the effects of adverse childhood experiences on older people. Nurs Older People. 2023 Jan 30;35(1):37-42. PMID: 36475401
“This article gives an overview of the long-term mental and physical effects of adverse childhood experiences and discusses how childhood trauma may manifest in older people. The author also discusses how nurses and unpaid family carers may themselves have been exposed to adverse childhood experiences and how this may affect their caring role.”
Race/Cultural Concerns
Patchin JW, Hinduja S.
Cyberbullying Among Asian American Youth Before and During the COVID-19 Pandemic. J Sch Health. 2023 Jan;93(1):82-87. PMID: 36221854
Using data from 3 unique national surveys of teens, “More youth have experienced cyberbullying since the beginning of the COVID-19 pandemic, with Asian American youth most likely to report increased victimization. In 2021, 23.2% of youth reported experiencing cyberbullying compared to 17.2% in 2019 and 16.7% in 2016. Among Asian American youth, 23.5% said they were cyberbullied because of their race in 2021, compared to 7.4% in 2019 and 13.9% in 2016.”
MacIntyre MM, Zare M, Williams MT.
Anxiety-Related Disorders in the Context of Racism. Curr Psychiatry Rep. 2023:1-13. PMID: 36645562
“Anxiety-related disorders were the most significant mediator for daily discrimination and suicidal thoughts, above both depression and substance use.” Authors summarize the research on different categories of racism vs. different types of anxiety-related disorders, including obsessive-compulsive, generalized, specific phobia, panic disorder, social anxiety disorder, and PTSD. “Considering racism with respect to these disorders is critical to providing effective treatment options and care for communities of color.”
Raza MM, Venkatesh KP, Kvedar JC.
Promoting racial equity in digital health: applying a cross-disciplinary equity framework. NPJ digital medicine. 2023;6(1):3. PMID: 36631555
Authors propose applying a previously-described framework to evaluate structural racism to three areas within digital medicine: artificial intelligence (AI) applications, wearable devices, and telehealth.
Baptist AP, Apter AJ, Gergen PJ, Jones BL.
Reducing Health Disparities in Asthma: How Can Progress be Made. J Allergy Clin Immunol Pract. 2023 Jan 21:S2213-2198(23)00073-9. PMID: 36693539
“In the United States, Black individuals have an asthma hospitalization rate that is 6× higher than that for White individuals, and an asthma mortality rate nearly 3× higher. This article will discuss the current state of health disparities in asthma in the United States…The types of asthma interventions (including case workers, technological advances, mobile asthma clinics, and environmental remediation) that have and have not been successful to decrease disparities will be reviewed. Finally, current resources and future actions are summarized in a table and in text, providing information that the allergist can use to make an impact on asthma health disparities in 2023.”
Perpetrators
Letourneau EJ, Roberts TWM, Malone L, Sun Y. No Check We Won't Write: A Report on the High Cost of Sex Offender Incarceration. Sex Abuse. 2023;35(1):54-82. PMID: 35318871
From a summary of publicly available information, “the annual cost to incarcerate adults convicted of sex crimes against children in the United States approaches $5.4 billion. This estimate does not include any costs incurred prior to incarceration (e.g., related to detection and prosecution) or post-release (e.g., related to supervision or registration). Nor does this estimate capture administrative and judicial costs associated with appeals, or administrative costs that cannot be extricated from other budgets…We believe information on the substantial funding dedicated to incarceration will be useful to U.S. federal, state, and local lawmakers and to international policymakers as they consider allocating resources to the development, evaluation and dissemination of effective prevention strategies aimed at keeping children safe from sexual abuse in the first place.”
Police and Court Systems
Wells JM, Walker VP.
"Do No Harm": Promoting Anti-Racist Policing in Pediatric Emergency Departments Through 20 Practice Change Considerations. Health Promot Pract. 2023:15248399221145160. PMID: 36648067
“We propose assessment and evaluation of current security and police encounters within pediatric EDs. We call for institution of policies that mitigate biases, address medical mistrust, distinguish clinical from criminal aggression, and minimize punitive contact with police. We outline a multitiered, patient-centered approach to disruptive and violent acts that prioritizes prevention, early intervention, and de-escalation strategies with a goal of reducing the perceived need for policing presence in pediatric EDs.”
Brady PQ, Zedaker SB, McKay K, Scott D.
The Darker the Skin, the Greater the Disparity? Why a Reliance on Visible Injuries Fosters Health, Legal, and Racial Disparities in Domestic Violence Complaints Involving Strangulation. J Interpers Violence. 2023:8862605221145726. PMID: 36695177
From an analysis of 133 standardized strangulation assessments by police officers who responded to family violence complaints, while racial/ethnic differences did not emerge for symptoms of disrupted airflow, compared to cases involving White/Asian survivors, officers were less likely to identify external injuries on Black survivors' neck, chin, and chest/shoulders. “The reliance on external injuries for justice is misguided given that assault injuries may be less visible among victims of color due to increased melanin in the skin.”
Providers
Vega S, Nienow SM, Huang MZ, Stover LB.
Medical Child Welfare Task Force: A Multidisciplinary Approach to Identifying Medical Child Abuse. Pediatrics. 2023 Feb 1;151(2):e2022058926. PMID: 36655381
“The Medical Child Welfare Task Force was developed to formalize education and collaboration around medical child abuse. The support of institutional leadership and involvement of multiple medical disciplines that commonly encounter these patients was vital to the implementation and long-term success of the endeavor…education was provided to clinicians in a variety of forums. Moreover, we leveraged the electronic medical record to streamline our ability to monitor cases of medical child abuse and communicate the concerns and plan of care to other providers, both within and outside of our health system.”
Mazzeo G, Bendixen R.
Community-Based Interventions for Childhood Trauma: A Scoping Review. OTJR (Thorofare N J). 2023 Jan;43(1):14-23. PMID: 35485320
In a research review of occupational therapy-related interventions to reduce trauma/PTSD such as play and art therapy, yoga, and equine-facilitated interventions, “Occupational therapists working in community settings appear to be underutilized in the treatment of children who have experienced trauma. Future studies should examine occupational therapists' potential to work alongside mental health providers in the community to optimize functional outcomes for traumatized children.”
Davis L, Aylward A, Buchanan R.
Trauma-Informed Yoga: Investigating an Intervention for Mitigating Adverse Childhood Experiences in Rural Contexts. Educ Stud. 2022;58(4):530-59. PMID: 36654845
Through a seven-week, twice weekly intervention of trauma-informed yoga for high school students in a rural Montana community, participants experienced statistically significant reductions in anxiety, depressive symptoms, and salivary cortisol levels; and an improvement in sleep duration. “Importantly, participant qualitative feedback indicated significant benefits in focus, relaxation, and overall well-being.”
Choi K, Boudreau AA, Dunn EC.
Raising the bar for measuring childhood adversity.
The Lancet Child & adolescent health. 2023;7(2):81-3. PMID: 36265505
“Awareness about the harmful effects of adverse childhood experiences (ACEs) has increased in the past decade among paediatric providers and researchers. Hundreds of observational studies have documented the prevalence and consequences of childhood adversity…However, substantial challenges in how to screen for, respond to, and address ACEs remain unresolved, raising the possibility that screening can do more harm than good. To mitigate these harms, we offer four recommendations to consider when deploying adversity screening: clarity is needed on what ACE scores do (and do not) measure; there needs to be capacity to deploy ACE screening tools safely and effectively; paediatric providers and health-care systems need to deploy screening at the right time and interpret screening results with context; and emerging evidence about the science of ACE measurement, including its limitations, should be used as the basis for action. A key criticism of ACE screening is the lack of widely available evidence-based interventions for clinical response.”
Marra J.
Care of Diverse Families: Foster Care and Adoption. FP essentials. 2023;524:7-13. PMID: 36626712
At any one time, more than 400,000 US children are in foster care. Although 59% are eventually reunited with their parents, some end up in other situations, including adoption which can be open, closed, and kinship. Approximately 1% of adoptees are from other countries. Approximately one-quarter of adoptions are transracial/transethnic. Adoptions by LGBTQIA+ are common. “Parents planning adoption should talk to the physician who will care for the child to review the child's health records, and continue with routine care after adoption. For international adoptions, numerous infectious disease tests are required before and after the child's arrival in the United States. Adoptees also should undergo developmental evaluation and screening for adverse childhood experiences and mental health issues.”
Zarnello L.
Implementing trauma-informed care across the lifespan to acknowledge childhood adverse event prevalence: best clinical practices. Nurse Pract. 2023;48(2):14-21. PMID: 36700790
“The aim of this article is to provide a general overview of trauma-informed care and to review current best-practice recommendations and models of care, thereby providing nurse practitioners with practical ways to empower a trauma-informed approach to care in their daily practice setting.”
Neuner F.
Physical and social trauma: Towards an integrative transdiagnostic perspective on psychological trauma that involves threats to status and belonging. Clin Psychol Rev. 2023;99:102219. PMID: 36395560
“Since the diagnosis of PTSD is restricted to events that involve threats to the physical or sexual integrity of a person, such as accidents and physical and sexual violence, these theories are not well suited to explain the psychopathological consequences of severe violations of one's social integrity, such as emotional abuse and bullying. However, it is evident that social threats contribute to a broad range of mental disorders and increase symptom severity in patients with posttraumatic stress disorder…Implications for treatment and further directions for research are discussed.”
Roebuck BS, Sattler PL, Clayton AK.
Violence and posttraumatic change (PTC). Psychol Trauma. 2023;15(1):18-26. PMID: 35084917
From a study of 435 diverse Canadian survivors of a variety of violent crimes, participants resisted the language of posttraumatic growth, and felt that the perception of “change” rather than growth was more responsive to their experience.
Frederickson A, Kern A, Langevin R.
Perinatal (Re)experiencing of Post-Traumatic Stress Disorder Symptoms for Survivors of Childhood Sexual Abuse: An Integrative Review. J Womens Health (Larchmt). 2023;32(1):78-93. PMID: 36201288
From a research review, pregnant “CSA [childhood sexual abuse] survivors (re)experienced PTSD symptoms as a result of (1) aspects of their medical care (vaginal examinations, male medical providers, lack of control, and restraint), (2) physical sensations during pregnancy, childbirth, and breastfeeding, and (3) sex of the child (worries over child becoming an abuser/abused, male genitalia). CSA survivor's PTSD symptoms of intrusion, dissociation, avoidance, and hyperarousal were significantly greater throughout the perinatal period compared with individuals without CSA or with other traumas…Findings point to the relevance of adopting trauma-informed practices with CSA survivors during their perinatal period.”
Prevention
Ma M, Orsi R, Brooks-Russell A.
Is Household Unemployment Associated With Increased Verbal and Physical Child Abuse During the COVID Pandemic? Child Maltreat. 2023 Feb;28(1):7-12. PMID: 35445620
Of 7,555 students from 51 schools in Colorado that participated in a survey administered from October to December 2020, having a parent or other adult in the home with a job loss was associated with higher odds of emotional or physical abuse. “The findings are consistent with child maltreatment prevention strategies focused on alleviating economic hardship.”
Austin AE, Shanahan ME, Frank M, et al.
Association of State Expansion of Supplemental Nutrition Assistance Program (SNAP) Eligibility With Rates of Child Protective Services-Investigated Reports. JAMA Pediatr. 2023 Jan 23:e225348. PMID: 36689239
In an analysis of CPS-investigated reports from 2006 to 2019 for all 50 states and the District of Columbia, “state expansion of SNAP eligibility through elimination of the asset test and increases in the income limit may contribute to decreases in rates of CPS-investigated reports,” for both Black and White children. “Although there were a few years between policy adoption and decreases in CPS-investigated reports for both policies, the magnitude of these decreases increased with greater time since policy adoption, indicating both sustained and accumulating benefits over time.”
Logan-Greene P, Bishop AS, Kim BE, Nurius PS.
Protective Factors Against Aggression and Antisocial Attitudes Among Probation Youth with Childhood Adversity Histories. Prev Sci. 2023 Jan;24(1):161-172. PMID: 36478337
Of 5378 youth on probation, “childhood maltreatment was the most salient form of adversity for increasing both aggression and antisocial attitudes. All protective factors (self-regulation, future orientation, positive parenting, prosocial connections) were associated with reduced aggression and antisocial attitudes, and muted the impact of childhood adversity on both outcomes.”
Calistro YT, Worthington K.
Strategies to Help CWS-Involved Parents Complete Substance Use Treatment and Protect their Children in Hawai'i. Hawai'i journal of health & social welfare. 2022;81(12 Suppl 3):37-42. PMID: 36660281
“Children in foster care because of parental SUD [substance use disorder] are less likely to be reunified with their parents. Experiences in foster care may cause long-term negative health consequences for the children. Early identification and engagement of parents in SUD treatment can improve outcomes for parents and children. The child welfare and SUD treatment systems in Hawai'i are not set up to work together to maximize the likelihood that parents will complete treatment and families will stay together. This article recommends evidence-based interventions including recovery coaches, peer partners, and Family Drug Courts (FDCs).”
Godbout N, Paradis A, Rassart CA, Sadikaj G, et al.
Parents' history of childhood interpersonal trauma and postpartum depressive symptoms: The moderating role of mindfulness. J Affect Disord. 2023 Mar 15;325:459-469. PMID: 36623567
For a randomly selected sample of 843 couples who recently welcomed a new child, more experience of childhood interpersonal trauma was associated with higher levels of postpartum depression, but this association was weaker in parents with higher dispositional mindfulness.”
Cramm L, Elgar FJ, Pickett W.
Corporal punishment bans and adolescent suicide rates: An international ecological study. Child Abuse Negl. 2023;137:106022. PMID: 36640589
“We used population-level administrative and mortality data from 97 countries spanning the years 1950 to 2017…National policies that permitted corporal punishment in all settings (homes, schools, daycares, and alternative care) were associated with a higher relative risk (RR) for suicide in females aged 15-19 (RR = 2.07), as were policies allowing corporal punishment in schools specifically (RR = 2.01). Partial bans of corporal punishment and bans of school corporal punishment showed lagged effects on suicide rates, the benefits of which peaked after 12 years for females aged 15-19 and after 13 years for males aged 15-19.”
Wang Y, Ahn H, Rose RA, Williams K.
Effects of school connectedness on the relationship between child maltreatment and child aggressive behavior: A mediation analysis. Child Abuse Negl. 2023;136:106021. PMID: 36638638
Using data from a fragile families study, “interventions targeted at improving school connectedness among adolescents involved in the child welfare system may promote positive outcomes by reducing aggressive behaviors among youth growing in fragile families. On-going trainings are needed for schoolteachers and social workers to better engage adolescents with child maltreatment at school.”
Felter J, Chung HL, Guth A, DiDonato S.
Implementation and Outcomes of the Trauma Ambassadors Program: A Case Study of Trauma-Informed Youth Leadership Development. Child & adolescent social work journal : C & A. 2023:1-17. PMID: 36624742
“The purpose of this article is to describe the implementation and outcomes of the Trauma Ambassador (TA) Program, a pilot youth leadership program guided by a community-university partnership that utilized a TIC [trauma-informed care] approach in an underserved East North Philadelphia neighborhood. Fourteen youth engaged in interactive trainings to build their understanding of trauma and to develop practical tools to support encounters with individuals with trauma histories.” Focus groups and individual interviews “identified a myriad of ways that youth and their community might benefit from a program like the one described…as TAs recognized their own trauma and were motivated to help others who may have trauma histories.”
Researchers
Alhowaymel FM, Kalmakis KA, Chiodo LM, et al.
Adverse Childhood Experiences and Chronic Diseases: Identifying a Cut-Point for ACE Scores. Int J Environ Res Public Health. 2023;20(2). PMID: 36674405
“The aim of this study is to clarify a cut-point at which ACEs are significantly associated with negative chronic health outcomes…analyses were performed on a sample of 10,047 adults. The results showed that a cut-point of four or more ACEs was significantly associated with increased rates of chronic disease. Participants with at least one chronic disease were almost 3 times more likely (OR = 2.8) to be in the high ACE group. A standardized cut-point for ACE scores will assist in future research examining the impact of high ACEs across cultures to study the effect of ACEs on health.”
Bosk EA.
Creating a parallel process: A new methodological framework for conducting Trauma-Informed Evaluation and Research (TIER) in mental health settings. Eval Program Plann. 2023;97:102229. PMID: 36645954
“Extensive research has made clear the need to implement TIC [trauma-informed care] in community-based mental health treatment…This work proposes a new methodological framework (TIER) and offers specific strategies for conducting trauma-informed evaluation and research based on SAM-SHA’s principles for TIC. These strategies include: 1) establishing emotional safety for clients by ensuring assessments are conducted face to face with one person; 2) promoting transparency by providing regular feedback on each assessment for every client; 3) increasing trustworthiness by linking client feedback to the core goals of the intervention; 4) facilitating collaboration by jointly planning the process for assessment; 5) empowering clients by recording any disagreement they may have with assessment findings; and 6) incorporating peer support in the planning phase.”
Edwards KM, Orchowski LM, Espelage DL, Temple JR.
What Is Not in the Methods Section: Challenges, Successes, and Lessons Learned From Conducting School-Based Interpersonal Violence Prevention Research. J Interpers Violence. 2023;38(3-4):4507-32. PMID: 35861274
“The purpose of this paper is to outline challenges, successes, and lessons learned from conducting school-based IV [interpersonal violence] prevention research…Specifically, we focus on the importance of researchers (1) doing research on the school/school district prior to reaching out about potential partnerships; (2) establishing relationships with school partners that are characterized by being present, trustworthiness, and respect as well as the prioritization of school partners' ideas over one's research agenda; (3) working collaboratively with school partners to conceptualize and fund school-driven ideas; (4) preparing for pushback, often from parents/caregivers; and (5) embracing reciprocity (i.e., do things to support your school partners that may not directly benefit you). Additional considerations for recruitment, enrollment, and retention; program implementation and data collection; and dissemination are discussed.”
Day PG, Woods SB, Gonzalez L, Fernandez-Criado R, Shakil A.
Validating the TeenHITSS to Assess Child Abuse in Adolescent Populations. Fam Med. 2023;55(1):12-9. PMID: 36656882
“The findings of this study suggest that TeenHITSS is a valid and reliable tool to screen for physical and sexual abuse in children ages 13 years and older in clinical settings, and can help health care providers detect adolescent abuse and initiate intervention and prevention of future abuse.”
Steele B, Neelakantan L, Jochim J, et al.
Measuring Violence Against Children: A COSMIN Systematic Review of the Psychometric and Administrative Properties of Adult Retrospective Self-report Instruments on Child Abuse and Neglect.
Trauma Violence Abuse. 2023:15248380221145912. PMID: 36695372
Authors review 77 adult retrospective child abuse and neglect measures. “The measures with the most robust evidence available across multiple contexts are the: ACE and ACE-IQ; FBQ and FBQ-U; CTQ and CTQ-SF; and ICAST-R. This review shows the strengths and weaknesses of retrospective violence against children measures.”
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