[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]
Child Abuse
Drake B, Fluke JD, Kim H, Orsi R, Stubblefield JL.
What Proportion of Foster Care Children Do Not Have Child Protective Services Reports? A Preliminary Look. Child Maltreat. 2022 Nov;27(4):596-604. PMID: 34308682
Using national data, authors found that between 8-35% of US children enter foster care for reasons other than maltreatment, including child behavior problem, alcohol abuse (child), child disability, drug abuse (child), parental incarceration, relinquishment, parental death, and being the sibling of a maltreated child. “A meaningfully large number of children are placed in foster care for reasons other than maltreatment investigated by CPS. Further research into these children is warranted to better inform foster care policy."
Walker BH, Brown DC, Walker CS, et. al.
Childhood adversity associated with poorer health: Evidence from the U.S. National Survey of Children's Health. Child Abuse Negl. 2022 Sep 9;134:105871. PMID: 36095924
From a large national survey, “We observed a dose-response relationship between ACE exposure and childhood physical, mental, and neurodevelopmental health problems in all age groups. The largest disparities exist between children with no ACEs and three or more ACEs. Children with three or more ACEs had significantly higher adjusted odds ratio of externalizing disorders [such as anger] (OR = 4.40), internalizing disorders [depression, anxiety] (OR = 5.13), neurodevelopmental disorders [ADHD] (OR = 2.40), and physical health problems (OR = 2.08).”
Mii AE, McCoy K, Coffey HM, Flood MF, Hansen ADJ.
Pathway to Expectations of Child Functioning Following Sexual Abuse: Caregiver Maltreatment History and Depressive Symptoms. J Interpers Violence. 2022 Oct;37(19-20):NP19132-NP19148. PMID: 34503348
From a study of 354 non-offending caregivers of children who had experienced sexual abuse, “caregivers who experienced maltreatment in childhood were more likely to experience depressive symptoms, which then lead to more negative expectations of their child's future functioning. As negative expectations are associated with poorer outcomes for children following CSA, increased attention to caregivers' depressive symptoms in treatment may promote more positive expectations for their child's postabuse functioning.”
Adult Manifestations of Child Abuse
Hakamata Y, Suzuki Y, Kobashikawa H, Hori H.
Neurobiology of early life adversity: A systematic review of meta-analyses towards an integrative account of its neurobiological trajectories to mental disorders. Front Neuroendocrinol. 2022 Apr;65:100994. PMID: 35331780
This detailed neurobiology research review assesses the impact of early life adversity on the stress hormone system, the immune system, and brain changes such as exaggerated response to emotionally negative information such as fear. These changes are found in those both with and without a diagnosed mental health disorder, and authors note future research needs regarding mental health prevention and treatment.
Devine C, Cohen-Cline H.
Social and Behavioral Pathways between Adverse Childhood Experiences and Poor Adult Physical Health: Mediation by Early Adulthood Experiences in a Low-Income Population. Int J Environ Res Public Health. 2022 Aug 25;19(17):10578. PMID: 36078291
From a large-scale study of Medicaid enrollees in Portland, Oregon, experiencing four or more ACEs increased the risk of poor adult physical health by 50%. This association was influenced by adult IPV and substance use, and to a lesser extent social isolation, but not work instability.
Yu HJ, Liu X, Yang HG, Chen R, He QQ.
The association of adverse childhood experiences and its subtypes with adulthood sleep problems: A systematic review and meta-analysis of cohort studies. Sleep Med. 2022 Oct;98:26-33. PMID: 35777139
In this research review, individual ACEs were associated with sleep problems, with increased problems with multiple ACEs. “ACE may have cumulative detrimental effects on sleep health.”
Brown SM, Rodriguez KE, Smith AD, Ricker A, Williamson AA.
Associations between childhood maltreatment and behavioral sleep disturbances across the lifespan: A systematic review. Sleep Med Rev. 2022 Aug;64:101621. PMID: 35367857
“Emerging research suggests that sleep disturbances may be a key behavioral health risk factor implicated in the relationship between maltreatment and poor health across the lifespan. This systematic review examined the association between maltreatment and behavioral sleep disturbances in childhood and adulthood…there was a robust association between childhood maltreatment and behavioral sleep disturbances.”
Zhao X, Jin L, Sun SB.
Early-life interparental relationship quality and late-life depressive symptoms: A mediation analysis. J Affect Disord. 2022 Sep 15;313:137-148. PMID: 35777496
In a study of Chinese elders, those who experienced poor early life interparental relationships “showed higher levels of and faster increases in depressive symptoms in late adulthood.” Depressive risk was increased if they also experienced childhood physical abuse, and/or poor relationships with their partner or children in adulthood. “Early-life interparental relationships exert a long-term effect on offspring's mental health.”
Eriksen JKD, Coello K, Stanislaus S, et. al.
Associations between childhood maltreatment and oxidative nucleoside damage in affective disorders. Eur Psychiatry. 2022 Aug 11;65(1):e46. PMID: 35950327
In this study of 468 patients with mood disorders, 151 unaffected first-degree relatives, and 241 healthy control persons, those with mood disorders showed higher levels of urinary oxidation stress products (markers of DNA and RNA damage and known to be associated with mood disorders), despite adjusting for various factors such as body mass index, smoking and alcohol use. Notably, especially childhood emotional abuse and emotional neglect were associated with oxidative stress.
Reinhard MA, Rek SV, Nenov-Matt T, et. al.
Association of loneliness and social network size in adulthood with childhood maltreatment: Analyses of a population-based and a clinical sample. Eur Psychiatry. 2022 Sep 5:1-14. PMID: 36059118
Using data from studies involving a German general population as well as adults being seen as outpatients for mental health treatment, “Loneliness is particularly associated with self-reported child maltreatment, and in this respect distinct from the social network size…This was particularly marked for emotional neglect and emotional abuse. Loneliness but not social network size mediated the relationship between childhood maltreatment and depressive symptoms.”
Brits B, Walker-Williams H, Fouché A.
Experiences of Women Survivors of Childhood Sexual Abuse in Relation to Nonsupportive Significant Adults. Trauma Violence Abuse. 2022 Oct;23(4):1027-1047. PMID: 33468018
This research review discusses women survivors of childhood sexual abuse and the impact of non-supportive significant adults before and during disclosure/discovery, and long-term consequences including psychological functioning, revictimization, and negative adult attachment to others.
Xiao Z, Murat Baldwin M, Wong SC, et. al.
The Impact of Childhood Psychological Maltreatment on Mental Health Outcomes in Adulthood: A Systematic Review and Meta-Analysis. Trauma Violence Abuse. 2022 Sep 19:15248380221122816. PMID: 36123796
“Childhood emotional abuse (CEA) and childhood emotional neglect (CEN) are the least well-studied forms of childhood maltreatment due to challenges in their definition and in detection. However, the available evidence suggests associations with multiple adulthood mental health problems in clinical (receiving mental health care) and non-clinical populations…including depression, anxiety, substance abuse, suicidal ideation or attempts, personality disorders, eating disorders, and other psychological symptoms…Furthermore, compared with the non-clinical population, individuals in clinical populations were more likely to have experienced emotional abuse and neglect during childhood. The review highlights the need for more research on emotional abuse and emotional neglect.”
Zhou J, Fan A, Zhou X, et. al.
Interrelationships between childhood maltreatment, depressive symptoms, functional impairment, and quality of life in patients with major depressive disorder: A network analysis approach. Child Abuse Negl. 2022 Oct;132:105787. PMID: 35917751
In this network analysis including multiple factors for 203 Chinese adults being treated for major depression, “emotional abuse emerged as the most pivotal network node, triggering both suicidal behaviors and depression symptoms…Emotional abuse appears to be an extremely harmful form of childhood maltreatment in the clinical presentation of depression.”
Lowe SR, James P, Arcaya MC, et. al.
Do levels of posttraumatic growth vary by type of traumatic event experienced? An analysis of the Nurses' Health Study II. Psychol Trauma. 2022 Oct;14(7):1221-1229. PMID: 32212776
From a substudy of 1574 participants from the Nurses’ Health Study II, looking at post-traumatic growth (PTG) after various types of traumatic events, and controlling for demographic variables, lifetime rape was consistently associated with lower PTG, both total PTG and all five PTG domains (Appreciation of Life, New Possibilities, Relating to Others, Personal Strength, and Spiritual Change), relative to other event types. Other findings included intimate partner violence being associated with higher Personal Strength and New Possibilities, while rape and IPV were associated with higher post-traumatic stress.
Huffmaster CE, Williams AY, Lee YL, et. al.
Association Between Adverse Childhood Experiences and Posttraumatic Stress Disorder Symptoms in Adults With Injury. JAMA Surg. 2022 Sep 21:e223116. PMID: 36129702
In this letter to the editor, and using 2019 data from one Alabama trauma center of 174 adult patients (mean age 42.5 years, 66.1% male) who had experienced traumatic injuries, total ACE score was associated with PTSD symptoms one month after the event, whereas mechanism of injury (whether intentional or not) and severity of injury, were not associated with PTSD symptoms. “Findings suggest that ACEs are associated with delayed psychological resilience after severe injury in adulthood, emphasizing the need for early detection and intervention. More research is needed to examine the trajectory of PTSD symptoms beyond 30 days in patients with high ACE scores.”
Siegel A, Lahav Y.
Emotion Regulation and Distress During the COVID-19 Pandemic: The Role of Childhood Abuse. J Interpers Violence. 2022 Sep;37(17-18):NP16302-NP16326. PMID: 34088243
From an online survey of 710 Israeli adults, half of whom were child abuse survivors, “Participants with a history of childhood abuse had elevated overall psychological distress as well as peritraumatic stress symptoms during the pandemic, compared to nonabused participants, above and beyond demographic characteristics and COVID-19-related stressors…The current findings suggest that a history of childhood abuse might be a risk factor for distress in the face of COVID-19, and that childhood abuse survivors would benefit from clinical interventions that promote emotion regulation skills during this ongoing global health crisis.”
Yuan B, Li J, Li K, Chen M.
Longstanding health risk across the life course: The influence of early-life experience on health status throughout the life span. J Biosoc Sci. 2022 Sep 19:1-27. PMID: 36120813
From a large national study of Chinese adults, “Results shown the significant associations between multiple forms of children adversities and health status in adolescence, and health status in mid and late adulthood, including self-rated general health problems, chronic conditions, body aches, and depression…Results suggested that the experience of multiple forms of adversities in childhood represented a substantial source of health risk throughout life.”
Faleschini S, Tiemeier H, Rifas-Shiman SL, et. al.
Longitudinal associations of psychosocial stressors with menopausal symptoms and well-being among women in midlife. Menopause. 2022 Nov 1;29(11):1247-1253. PMID: 36099555
682 women were enrolled in a study during pregnancy (and queried at that time about abuse experiences from childhood to present pregnancy), and then followed through menopause. A history of physical abuse (reported by 37.3%) was associated with worse menopausal symptoms, worse general health, and greater depressive symptoms. History of sexual abuse (7.7%) was associated with worse menopausal symptoms and worse general health but not with depressive symptoms…“Psychosocial stressors were associated with worse menopausal symptoms and well-being decades after initial report.”
Adolescents
Espelage DL, Ingram KM, Hong JS, Merrin GJ.
Bullying as a Developmental Precursor to Sexual and Dating Violence Across Adolescence: Decade in Review.Trauma Violence Abuse. 2022 Oct;23(4):1358-1370. PMID: 34519239
Authors review 10 years of research on the connection between bullying as a precursor to IPV in adolescence, including potential mechanisms, the efficacy of prevention efforts, and gaps in research.
Hornor G, Billa A, Daniels A, et. al.
Online Sexual Solicitation of Children and Adolescents in a High-Risk Population. J Pediatr Health Care. 2022 Sep-Oct;36(5):449-456. PMID: 35644705
Of 325 children/adolescents aged 8-18 years seen at a Child Advocacy Center with concerns about sexual abuse, 42.8% denied talking to anyone online that they had not met offline (face to face in real life), 27.1% reported talking to individuals online that they had not met offline but never talking about sex; 20% reported online sexual solicitation with individuals they had not met offline; and 10.2% reported highest-risk behaviors online involving meeting someone offline or having sex with someone offline whom they had met online. “Children who have been sexually abused are at increased risk for sexual solicitation.”
Jackson DB, Testa A, Woodward KP, et. al.
Adverse Childhood Experiences and Cardiovascular Risk among Young Adults: Findings from the 2019 Behavioral Risk Factor Surveillance System. Int J Environ Res Public Health. 2022 Sep 16;19(18):11710. PMID: 36141983
From a national youth study, “young adults who have experienced a greater number of ACEs have a higher likelihood of having moderate to high cardiovascular risk compared to those who have zero or few reported ACEs…young adults generally have a significant cardiovascular health risk resulting from heightened stress, poor diet, lack of sleep, decreased physical activity, and increased tobacco, alcohol, and drug use. Compounding these known health risks is the deficient ‘transition of care’ process from pediatric to adult medicine for young adults. As a result, many young adults do not receive age-appropriate screening or anticipatory guidance promoting healthy behaviors.” Poor mental health and cumulative disadvantage also factor into cardiovascular risk.
Kim HK, Bruce J.
Role of Risk Taking and Inhibitory Control in Alcohol Use Among Maltreated Adolescents and Nonmaltreated Adolescents. Child Maltreat. 2022 Nov;27(4):615-625. PMID: 34278833
For 129 maltreated adolescents and their parents and 102 matched controls, all of whom completed 3 annual assessments, “Childhood maltreatment was not directly associated with alcohol use in middle adolescence but was significantly associated with deficits in inhibitory control [the ability to suppress or countermand a thought, action, or feeling] in early adolescence, which, in turn, led to significantly increased alcohol use in middle adolescence.”
Stewart-Tufescu A, Struck S, Taillieu T, et. al.
ACEs and Education Outcomes among Adolescents: Linking Survey and Administrative Data. Int J Environ Res Public Health. 2022 Sep 14;19(18):11564. PMID: 36141833
From a study of adolescents in Manitoba, Canada, “Adolescents with an ACE history had significantly increased likelihood of having ever been suspended from school (adjusted odds ratio (aOR) = 3.33), of lower grades (adjusted relative risk ratio (aRRR) = 3.21), and of chronic school absenteeism (aRRR = 2.45) compared with adolescents without an ACE history after adjusting for sociodemographic variables.”
Albers LD, Grigsby TJ, Benjamin SM, et. al.
Adverse childhood experiences and sleep difficulties among young adult college students. J Sleep Res. 2022 Oct;31(5):e13595. PMID: 35366024
From a pre-pandemic sample of college students in California and Texas, 40% reported ACEs. Compared to students with no ACEs, those with a variety of ACEs had 1.5 – 3.1 times increased risk for different sleep difficulties.
Kobulsky JM, Cederbaum JA, Wildfeuer R, et. al.
Comparing the prevalence of sexual behaviors and victimization among adolescents based on child welfare system involvement. Child Abuse Negl. 2022 Sep 14;134:105883. PMID: 36115325
From a survey of Los Angeles students, “Greater reported sexual behavior and victimization among foster care youths was found, relative to youths without child welfare system involvement (maximum OR = 9.8). Youth with child welfare system involvement but not placed in foster care reported more unsafe sex, sexting because of pressure, finding a sex partner online, having sex with a partner met online, and forced sex (maximum OR = 10.4). Sexting was associated with forced sex and dating sexual assault, finding a sexual partner online, and physical violence…Targeted prevention is needed for online and offline sexual risks and victimization among youth with child welfare system involvement.”
Culyba AJ, Riley AT, Corona G, Miller E, Carley KM.
Adolescent-Adult Social Networks and Experiences of Violence Among Black Youth in Neighborhoods With High Levels of Community Violence. J Adolesc Health. 2022 Oct;71(4):494-501. PMID: 35717325
From surveys of 106 youth from urban Pittsburgh, Pennsylvania neighborhoods with high levels of community violence, and their adult networks, mean youth participant age was 16.7 years, 56% self-identified as female, and 84% as Black or African-American. Youth identified a mean of 4.8 adult supports. Identifying at least one immediate family member in their network was inversely related to violence perpetration, victimization, and witnessing violence, by about half. The percent of adult supports involved in violence was directly associated with violence perpetration, victimization, and witnessing violence, by almost 2 times more.
Babcock Fenerci RL, Jenkins GA, Gilbert AC, et. al.
Maltreatment history and reasons for self-injurious behavior among adolescents engaged in non-suicidal self-injury versus adolescents who attempted suicide. Suicide Life Threat Behav. 2022 Oct;52(5):898-907. PMID: 35635356
Comparing groups of adolescents with non-suicidal self-injury (NSSI), suicide attempts (SA), and a control group (TDC), “Maltreatment rates were as follows: 90% NSSI group, 76% SA group, and 40% TDC group. Adolescents in the NSSI group reported significantly higher rates of emotional neglect compared to the SA group. Maltreated adolescents in the NSSI and SA groups reported the same top three SIB [self-injurious behaviors] reasons: (1) get rid of bad feelings, (2) mental state at the time, and (3) problems with family. However, maltreated NSSI participants were significantly more likely to engage in SIB for emotion regulation reasons than maltreated SA participants, who were more likely to engage in SIB for interpersonal reasons.”
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