[Editor's note: Dr. Harise Stein at Stanford University edits a web site — abuseresearch.info — that focuses on the health effects of abuse, and includes research articles on ACEs. Every month, she's posting the summaries of the abstracts and links to research articles that address only ACEs. Thank you, Harise!! -- Jane Stevens]
Tang R, Howe LD, Suderman M, et. al.
Adverse childhood experiences, DNA methylation age acceleration, and cortisol in UK children. Clin Epigenetics. 2020 Apr 7;12(1):55. PMID: 32264940
For 974 UK children, exposure to four or more ACEs, or separately emotional abuse or physical abuse during age 0-14 years were each associated at age 17 with DNA increased cellular aging of approximately 1-3 years for girls, but not for boys.
Dunn EC, Soare TW, Zhu Y, et. al.
Sensitive Periods for the Effect of Childhood Adversity on DNA Methylation. Biol Psychiatry. 2019 May 15;85(10):838-849. PMID: 30905381
Using data from a mother-child pair study when children were age 7, three theories of DNA methylation (changes to DNA in response to abuse - for example to the stress hormone or immune systems) were analyzed as predictors of methylation: timing of adversity, cumulative trauma, or more recent trauma having greater impact. Results were best explained by developmental timing, especially abuse prior to age 3, rather than accumulation or recency of exposure.
Grey HR, Ford K, Bellis MA, Lowey H, Wood S.
Associations between childhood deaths and adverse childhood experiences. Child Abuse Negl. 2019 Apr;90:22-31. PMID: 30716652
Of 489 cases of child deaths collected by child death overview panels, 20% were identified as having 4+ ACEs (retroactively assigned). Deaths of children with 4+ ACEs were 22.26 times more likely than those with 0 ACEs to be classified as ‘avoidable and non-natural’.
Epel ES.
Can Childhood Adversity Affect Telomeres of the Next Generation? Possible Mechanisms, Implications, and Next-Generation Research. Am J Psychiatry. 2020 Jan 1;177(1):7-9. PMID: 31892296
Editorial review of what is known about the effects of ACEs on telomeres (a measure of cellular aging), possible transmission to the next generation, and upcoming important research studies.
Pierce JB, Kershaw KN, Kiefe CI, et. al.
Association of Childhood Psychosocial Environment With 30-Year Cardiovascular Disease Incidence and Mortality in Middle Age. J Am Heart Assoc. 2020 May 5;9(9):e015326. PMID: 32342717
Survival curves show that for 3646 US urban adults followed for 30 years, and even after controlling for cardiovascular disease (CVD) risk factors, increasing childhood adversity scores were associated with increased CVD and all-cause mortality later in life. Those with the most severe abuse were more than 50% more likely to experience an event such as heart attack or stroke.
Li L, Pinto Pereira SM, Power C.
Childhood maltreatment and biomarkers for cardiometabolic disease in mid-adulthood in a prospective British birth cohort. BMJ Open. 2019 Mar 23;9(3):e024079. PMID: 30904846
Of 9000 British adults aged 45 years, “Childhood maltreatments, particularly neglect and physical abuse, were associated with greater adiposity [body areas of fat] and poorer lipid and HbA1c [blood sugar] profiles decades later in adulthood.”
Badley EM, Shields M, O'Donnell S, Hovdestad WE, Tonmyr L.
Childhood Maltreatment as a Risk Factor for Arthritis. Arthritis Care Res (Hoboken). 2019 Oct;71(10):1366-1371. PMID: 30328298
From a large Canadian survey, 17.5% reported medically diagnosed arthritis. After controlling for sociodemographic variables, severe and/or frequent childhood physical abuse and childhood exposure to IPV were each associated with an increased risk of arthritis in a dose/response relationship.
Hindin P, Btoush R, Carmody DP.
History of Childhood Abuse and Risk for Cervical Cancer Among Women in Low-Income Areas. J Womens Health (Larchmt). 2019 Jan;28(1):23-29. PMID: 30265615
Of 410 low-income women in New Jersey, history of childhood abuse was associated with 96% higher odds of being at risk of cervical cancer. Factors involved in this association included failure to receive a Pap test, higher levels of smoking, perceived stress, and risky sexual behavior.
Riedl D, Lampe A, Exenberger S, Nolte T, Trawöger I, Beck T.
Prevalence of adverse childhood experiences (ACEs) and associated physical and mental health problems amongst hospital patients: Results from a cross-sectional study. Gen Hosp Psychiatry. 2020 May-Jun;64:80-86. PMID: 32304934
Of 2392 Austrian adults seen at one hospital as inpatients or outpatients, 36.1% reported at least one ACE, and 6.3% 4 or more. “Most frequent forms of ACE were emotional abuse (18.3%), peer abuse (14.2%), and neglect (12.3%). ACEs were significantly associated with increased odds ratios for various physical diseases, mental health problems and domestic violence.”
Schückher F, Sellin T, Engström I, Berglund K.
History of childhood abuse is associated with less positive treatment outcomes in socially stable women with alcohol use disorder. BMC Womens Health. 2019 Dec 12;19(1):159. PMID: 31830964
Of 75 Swedish socially stable women enrolled in a alcohol use disorder program, 50.7% reported a history of childhood abuse. At 12 month treatment follow-up, abstinence was reported by 55.6% in the non-abused group, vs. 13.3% in the abused group.
Lippard ETC, Nemeroff CB.
The Devastating Clinical Consequences of Child Abuse and Neglect: Increased Disease Vulnerability and Poor Treatment Response in Mood Disorders. Am J Psychiatry. 2020 Jan 1;177(1):20-36. PMID: 31537091
“A large body of evidence has demonstrated that exposure to childhood maltreatment at any stage of development…is associated with a marked increase in risk for psychiatric and medical disorders…and increased risk for first mood episode, episode recurrence, greater comorbidities, and increased risk for suicidal ideation and attempts.” Authors discuss several candidate genes and environmental factors, and modifiable mechanisms to improve both treatment and prevention.
Angelakis I, Gillespie EL, Panagioti M.
Childhood maltreatment and adult suicidality: a comprehensive systematic review with meta-analysis. Psychol Med. 2019 May;49(7):1057-1078. PMID: 30608046
From a comprehensive research review, childhood sexual abuse, physical abuse and emotional abuse were each associated with a 2 to 3 fold increased risk for suicidal ideation and suicide attempts, with complex childhood abuse associated with a 5.18 times increased risk for attempts. “The main outstanding challenge is to better understand the mechanisms which underpin the development of suicidality in people exposed to childhood maltreatment because current evidence is scarce.”
Maier A, Gieling C, Heinen-Ludwig L, et. al.
Association of Childhood Maltreatment With Interpersonal Distance and Social Touch Preferences in Adulthood. Am J Psychiatry. 2020 Jan 1;177(1):37-46. PMID: 31416339
Of 92 medication-free adults with low, medium and high levels of childhood maltreatment, “higher childhood maltreatment levels are associated with hypersensitivity characterized by a preference for larger interpersonal distance and discomfort of fast touch”, manifested in a clinical setting and in brain scans. “These results may shed light on why individuals with severe childhood maltreatment exhibit an increased susceptibility to interpersonal dysfunctions and psychiatric disorders in adulthood.”
Mondelli V, Dazzan P.
Childhood trauma and psychosis: Moving the field forward. Schizophr Res. 2019 Mar;205:1-3. PMID: 30765250
In an introduction to this special journal issue on childhood trauma and psychosis, “early adverse experiences play a significant role not only in increasing the risk of developing psychosis, but also in its course and outcome…there may be a dose-response relationship between number and severity of adverse events and risk, severity, and chronicity of psychotic disorders.”
Elkins J, Miller KM, Briggs HE, Kim I, Mowbray O, Orellana ER.
Associations between Adverse Childhood Experiences, Major Depressive Episode and Chronic Physical Health in Adolescents: Moderation of Race/Ethnicity. Soc Work Public Health. 2019;34(5):444-456. PMID: 31117927
“Results underscore the importance of examining associations between ACE and adolescent well-being by race/ethnicity. The need for trauma-informed and culturally responsive services for adolescents is discussed.”
Briggs L, Fronek P.
Incorporating Demoralization into Social Work Practice. Soc Work. 2019 Apr 1;64(2):157-164. PMID: 30715546
“Demoralization occurs when life becomes so overwhelming that daily functioning is affected and people lose all hope, agency, and the capacity to overcome their circumstances. Although a demoralized state is not recognized as a mental illness…it is often confused with psychiatric disorders and its presence can lead to clinical conditions and suicide. This article discusses demoralization and its place in social work practice, identification and measurement, and appropriate psychosocial interventions.”
Maunder RG, Hunter JJ, Tannenbaum DW, Le TL, Lay C.
Physicians' knowledge and practices regarding screening adult patients for adverse childhood experiences: a survey. BMC Health Serv Res. 2020 Apr 15;20(1):314. PMID: 32293444
From a survey of Canadian family physicians, psychiatrists, and specialists, responses to ACEs screening were: family physicians - "when indicated" (66.3%), psychiatrists - "routinely" (91.3%), and other specialists - "never or not usually" (77.1%). Screening was not related to knowledge of prevalence of ACEs, or of the link between ACEs and mental health, but was significantly associated with knowing that ACEs are associated with physical health…The most prevalent perceived barriers to screening were lack of mental health resources (59.0%), lack of time (59.0%), concern about causing distress (49.7%) and lack of confidence (43.7%).”
Copado IA, Distelberg B.
Use of the Whole Child Assessment to identify children at risk of poor outcomes. Child Abuse Negl. 2020 Jun;104:104489. PMID: 32289566
“We found strong relationships between Child-ACEs reported on the Whole Child Assessment and odds of poor child health and psychosocial outcomes in pediatric patients age 5-11 years old, which supports the validity of using the Whole Child Assessment at well-child visits…Compared to lower risk patients (0-1 reported ACE exposure), patients with 2 or more reported exposures were statistically significantly more likely to experience sadness, anger, sleep problems, bullying, school problems, and enuresis [bed-wetting].”
Logan-Greene P, Kim BKE, Nurius PS.
Adversity profiles among court-involved youth: Translating system data into trauma-responsive programming. Child Abuse Negl. 2020 Jun;104:104465. PMID: 32278929
Using data from 5,378 medium-to-high-risk youth on probation, authors identified 6 “groups” based on graphs of extent of various ACEs for each group. Graph shows extent of mental health, suicidality, alcohol and drug use for each group. Awareness of these adversity profiles can assist judicial and other services with youth support needs.
Thomson P, Jaque SV.
History of childhood adversity and coping strategies: Positive flow and creative experiences. Child Abuse Negl. 2019 Apr;90:185-192. PMID: 30802732
In this community and university sample of adults (n = 577), 40.4% had no ACEs, 43.4% had 1-3 ACEs, and 16.3% had ≥4 ACEs. There were no group differences for task-oriented and avoidant-oriented coping, however those with 4+ ACEs “endorsed more intense creative experiences compared to the no-ACE and 1-3 ACE groups”. The 4+ group also had heightened anxiety, internalized shame, dissociative processing, and emotion-oriented coping.
Joyce A, Green C, Kearney S, Leung L, Ollis D.
Alignment and political will: upscaling an Australian respectful relationships program. Health Promot Int. 2019 Oct 1;34(5):892-901. PMID: 29850904
“Many small scale efficacious programs and interventions need to be 'scaled-up' in order to reach a larger population. Although…interventions deemed suitable for upscaling need to have demonstrated effectiveness, be able to be implemented cost-effectively and be accepted by intended recipients, these factors alone are insufficient…Upscaling research often identifies political will as a key factor in explaining whether programs are supported and up-scaled…political will is not a stand-alone factor as depicted by upscaling models, but rather is the end point of a complex process that involves many elements including the establishment of networks and aligned programs that can capitalize when opportunities arise.”
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