Dataset Information

Positive Childhood Experiences and Adult Mental and Relational Health in a Statewide Sample: Associations Across Adverse Childhood Experiences Levels.

ABSTRACT: Importance:Associations between adverse childhood experiences (ACEs) and risks for adult depression, poor mental health, and insufficient social and emotional support have been documented. Less is known about how positive childhood experiences (PCEs) co-occur with and may modulate the effect of ACEs on adult mental and relational health. Objective:To evaluate associations between adult-reported PCEs and (1) adult depression and/or poor mental health (D/PMH) and (2) adult-reported social and emotional support (ARSES) across ACEs exposure levels. Design, Setting, and Participants:Data were from the cross-sectional 2015 Wisconsin Behavioral Risk Factor Survey, a random digit-dial telephone survey of noninstitutionalized Wisconsin adults 18 years and older (n = 6188). Data were weighted to be representative of the entire population of Wisconsin adults in 2015. Data were analyzed between September 2016 and January 2019. Main Outcomes and Measures:The definition of D/PMH includes adults with a depression diagnosis (ever) and/or 14 or more poor mental health days in the past month. The definition of PCEs includes 7 positive interpersonal experiences with family, friends, and in school/the community. Standard Behavioral Risk Factor Survey ACEs and ARSES variables were used. Results:In the 2015 Wisconsin Behavioral Risk Factor Survey sample of adults (50.7% women; 84.9% white), the adjusted odds of D/PMH were 72% lower (OR, 0.28; 95% CI, 0.21-0.39) for adults reporting 6 to 7 vs 0 to 2 PCEs (12.6% vs 48.2%). Odds were 50% lower (OR, 0.50; 95% CI, 0.36-0.69) for those reporting 3 to 5 vs 0 to 2 PCEs (25.1% vs 48.2%). Associations were similar in magnitude for adults reporting 1, 2 to 3, or 4 to 8 ACEs. The adjusted odds that adults reported "always" on the ARSES variable were 3.53 times (95% CI, 2.60-4.80) greater for adults with 6 to 7 vs 0 to 2 PCEs. Associations for 3 to 5 PCEs were not significant. The PCE associations with D/PMH remained stable across each ACEs exposure level when controlling for ARSES. Conclusions and Relevance:Positive childhood experiences show dose-response associations with D/PMH and ARSES after accounting for exposure to ACEs. The proactive promotion of PCEs for children may reduce risk for adult D/PMH and promote adult relational health. Joint assessment of PCEs and ACEs may better target needs and interventions and enable a focus on building strengths to promote well-being. Findings support prioritizing possibilities to foster safe, stable nurturing relationships for children that consider the health outcomes of positive experiences.

SUBMITTER: Bethell C

PROVIDER: S-EPMC6735495 | biostudies-literature | 2019 Sep

REPOSITORIES: biostudies-literature

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Positive Childhood Experiences and Adult Mental and Relational Health in a Statewide Sample: Associations Across Adverse Childhood Experiences Levels.

Bethell Christina C Jones Jennifer J Gombojav Narangerel N Linkenbach Jeff J Sege Robert R

JAMA pediatrics 20191104 11

<h4>Importance</h4>Associations between adverse childhood experiences (ACEs) and risks for adult depression, poor mental health, and insufficient social and emotional support have been documented. Less is known about how positive childhood experiences (PCEs) co-occur with and may modulate the effect of ACEs on adult mental and relational health.<h4>Objective</h4>To evaluate associations between adult-reported PCEs and (1) adult depression and/or poor mental health (D/PMH) and (2) adult-reported ...[more]

PMID: 31498386

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Project description:Background: Many studies demonstrated the relationship between adverse childhood experiences (ACEs) and diminished health functioning in adulthood. A growing literature has shown that positive childhood experiences (PCEs) co-occurring with ACEs reduce the risks for negative outcomes. Objective: The aim was to investigate how ACEs and PCEs are simultaneously associated with health outcomes in adulthood, including self-rated health, physical and mental health outcomes, and health-risk behaviours. Methods: A panel sample of 4,847 Slovenian adults was used and the data were weighted to closely resemble the Slovenian population. A series of logistic regression analyses were performed to examine how ACEs and PCEs predict the risk of various health outcomes. Results: Significant associations, as measured by adjusted odds ratios, were found between higher ACEs exposure and each of the 16 health outcomes evaluated. Adjusting for above median PCEs attenuated the association between ACEs and 6 health outcomes (poor self-rated physical and mental health, depression, anxiety, suicide attempt, physical inactivity; OR for ≥ 4 vs. 0 ACEs, 1.48-9.34). Mirroring these findings, above median PCEs were associated with lowered odds of these 6 health outcomes after adjusting for ACEs (OR for above vs. below median PCEs, 0.46-0.67), but not with odds of physical health outcomes and most of the health-risk behaviours. Stratified analyses by ACEs exposure level showed that the association between PCEs and self-rated health remained stable across ACEs exposure levels, while the association between PCEs and mental health outcomes and physical inactivity varied across ACEs exposure levels. Conclusions: Our results suggest that above median PCEs attenuate the association between ACEs and poor self-rated health, mental health problems, and physical inactivity in later life, and are negatively associated with these health problems even in the concurrent presence of ACEs. Interventions to promote PCEs can help to reduce unfavourable long-term health outcomes following childhood adversity.

Project description:BackgroundResearch cites a strong, dose-response relationship between adverse childhood experiences (ACEs) and poor adult mental health outcomes including anxiety, depression, post-traumatic stress disorder (PTSD), self-harm, suicidality, and psychotic-like experiences.AimTo systematically investigate the existence and strength of association between ACEs and adult mental health outcomes in prospective longitudinal studies. The review will focus on the outcomes: anxiety, depression, PTSD, self-harm, suicidal ideation, and psychotic-like experiences.MethodsTwelve electronic databases will be searched: Embase, PsycINFO, MEDLINE, and Global Health through the OVID interface. ProQuest will be used to search Public Affairs Information Service (PAIS), Dissertations and Theses, Sociology Database (including Sociological Abstracts and Social Services Abstracts), PTSDpubs (formerly The Published International Literature on Traumatic Stress (PILOTS) Database) and Applied Social Sciences Index and Abstracts (ASSIA). CINAHL, World Health Organisation (WHO) Global Index Medicus, and WHO Violence Info will also be searched. Eligible studies will be double screened, assessed, and their data will be extracted. Any disagreement throughout these processes will be settled by a third reviewer. If enough studies meet the criteria and the methodological quality of each study is sufficient, a meta-analysis will be conducted.AnalysisA narrative synthesis of included studies and the associations between ACEs and adult mental health will be completed. If the number of studies included per mental health outcome is two or more, a multi-level meta-analysis will be completed using odds ratio effect sizes as outcomes.DiscussionThis review will contribute to the existing body of literature supporting the long-term effects of ACEs on adult mental health. This review adds to previous reviews that have either synthesised cross-sectional associations between ACEs and mental health outcomes, synthesised longitudinal studies exploring the effect of ACEs on different physical and mental health outcomes or synthesised longitudinal studies exploring the effect of ACEs on the same mental health outcomes using different methods. This review aims to identify methodological weaknesses and knowledge gaps in current literature that can be addressed in future primary studies.Systematic review registrationThis protocol has been registered in PROSPERO (CRD42021297882).

Project description:Childhood adversity is a well-established risk factor for mental health problems during adolescence. Using data from the Fragile Families and Child Wellbeing Study and latent class analysis (LCA), we examined patterns of exposure to ten adverse childhood experiences (ACEs), including socioeconomic adversity, among non-Hispanic (NH) White, NH Black, and Hispanic 9 year olds and determined associations between membership in ACE exposure "classes" and depression and anxiety scores at age 15 (N = 2849). Parental separation/divorce, economic hardship, and paternal incarceration were the most common ACEs. ACE prevalence was significantly higher among Blacks and Hispanics. ACEs clustered into four classes for Whites and Hispanics and three classes for Blacks. Over half of Whites were classified in the 'Low Adversity' class. Conversely, most Black and Hispanic adolescents were classified in the 'High Socioeconomic Adversity and Paternal Incarceration' class, characterized by above average probabilities of experiencing family economic hardship, parental separation/divorce, low maternal education, and paternal incarceration. A small share of adolescents in all three racial/ethnic groups were in the 'High Global Adversity' class, characterized by high probability of exposure to most ACEs, including physical and psychological abuse. Finally, ACE class membership was differentially associated with anxiety and depression across the three racial/ethnic groups, with generally larger differences in mental health scores across ACE groups for Whites than for Blacks and Hispanics. Our findings suggest that studies on the associations between ACEs and health outcomes that do not include childhood economic adversity risk underestimating the role of ACEs on mental health among racial/ethnic minorities. Moreover, different patterns of ACE exposure are differentially linked to anxiety and depression, and ACE group membership differences in anxiety and depression vary by racial/ethnic group. Findings suggest the need for racially tailored prevention and intervention strategies.

Project description:ObjectivesTransdiagnostic risk factors-disrupted processes common to psychopathology-link adverse childhood experiences to severe mental disorders (i.e. major depressive disorder, bipolar disorder, and schizophrenia spectrum disorders); however, transdiagnostic protective factors are understudied. The present study investigated the association between a positive mental health framework of protective intra- and interpersonal resources and severe mental disorders in individuals with adverse childhood experiences. We hypothesized that (1) individuals with adverse childhood experiences will experience more severe mental disorders and poorer intra- and interpersonal resources than those without adverse childhood experiences; (2) intrapersonal (e.g. general coping) and interpersonal resources (e.g. emotional support) will interact to predict severe mental disorders.MethodsA total of 1929 adults participated in this population-based study. Participants were assessed for adverse childhood experiences, severe mental disorders, and intra- and interpersonal resources (general coping, general affect, emotional support, interpersonal skills, spirituality, and personal growth and autonomy) via structured interviews and self-reports.ResultsAs hypothesized, individuals with adverse childhood experiences (62.6%) experienced more severe mental disorders and poorer intra- and interpersonal resources than those without adverse childhood experiences. Among those with adverse childhood experiences, emotional support interacted with general coping and general affect to predict severe mental disorders; general coping and general affect were negatively associated with severe mental disorders at high (+1 SD) and low (-1 SD) emotional support, respectively.ConclusionsThe present study identified interactions between specific intrapersonal (i.e. general coping and general affect) and interpersonal resources (i.e. emotional support); knowing among whom and when to intervene are essential for optimal treatment of adverse childhood experiences and severe mental disorders.

Dataset Information

Positive Childhood Experiences and Adult Mental and Relational Health in a Statewide Sample: Associations Across Adverse Childhood Experiences Levels.

Publications

Positive Childhood Experiences and Adult Mental and Relational Health in a Statewide Sample: Associations Across Adverse Childhood Experiences Levels.

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