Adverse Childhood Experiences and Their Relationship with Poor Sexual Health Outcomes: Results from Four Cross-Sectional Surveys.
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SUBMITTER: Wood SK
PROVIDER: S-EPMC9316235 | biostudies-literature |
REPOSITORIES: biostudies-literature
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Project description:ImportanceAdverse childhood experiences (ACEs) are well-established risk factors for health problems in a population. However, it is not known whether screening for ACEs can accurately identify individuals who develop later health problems.ObjectiveTo test the predictive accuracy of ACE screening for later health problems.Design, setting, and participantsThis study comprised 2 birth cohorts: the Environmental Risk (E-Risk) Longitudinal Twin Study observed 2232 participants born during the period from 1994 to 1995 until they were aged 18 years (2012-2014); the Dunedin Multidisciplinary Health and Development Study observed 1037 participants born during the period from 1972 to 1973 until they were aged 45 years (2017-2019). Statistical analysis was performed from May 28, 2018, to July 29, 2020.ExposuresACEs were measured prospectively in childhood through repeated interviews and observations in both cohorts. ACEs were also measured retrospectively in the Dunedin cohort through interviews at 38 years.Main outcomes and measuresHealth outcomes were assessed at 18 years in E-Risk and at 45 years in the Dunedin cohort. Mental health problems were assessed through clinical interviews using the Diagnostic Interview Schedule. Physical health problems were assessed through interviews, anthropometric measurements, and blood collection.ResultsOf 2232 E-Risk participants, 2009 (1051 girls [52%]) were included in the analysis. Of 1037 Dunedin cohort participants, 918 (460 boys [50%]) were included in the analysis. In E-Risk, children with higher ACE scores had greater risk of later health problems (any mental health problem: relative risk, 1.14 [95% CI, 1.10-1.18] per each additional ACE; any physical health problem: relative risk, 1.09 [95% CI, 1.07-1.12] per each additional ACE). ACE scores were associated with health problems independent of other information typically available to clinicians (ie, sex, socioeconomic disadvantage, and history of health problems). However, ACE scores had poor accuracy in predicting an individual's risk of later health problems (any mental health problem: area under the receiver operating characteristic curve, 0.58 [95% CI, 0.56-0.61]; any physical health problem: area under the receiver operating characteristic curve, 0.60 [95% CI, 0.58-0.63]; chance prediction: area under the receiver operating characteristic curve, 0.50). Findings were consistent in the Dunedin cohort using both prospective and retrospective ACE measures.Conclusions and relevanceThis study suggests that, although ACE scores can forecast mean group differences in health, they have poor accuracy in predicting an individual's risk of later health problems. Therefore, targeting interventions based on ACE screening is likely to be ineffective in preventing poor health outcomes.
| S-EPMC7835926 | biostudies-literature
Project description:ObjectivesSeveral studies have linked diabetes mellitus to adverse childhood experiences (ACEs). While a number of studies have examined the association between ACEs and diabetes in Western populations, few have done it in Asian populations. The current study aimed to examine (1) the association between ACEs and diabetes, including the association after age stratification, and (2) the association of comorbid depression, resource use and health-related quality of life (HRQoL) among those with diabetes and ACEs in Singapore.SettingsParticipants were surveyed in their homes or any other preferred venue of their choice.Participants6126 individuals aged 18 years and above were randomly selected among Singapore residents.DesignCross-sectional nationwide epidemiological study.ResultsExposure to any ACE was not associated with increased odds of diabetes; however, those who had experienced parental separation, death or divorce of a parent had higher odds of diabetes. In addition, we observed significant interaction between age and ACEs in relation to odds of diabetes. ACEs were significantly associated with higher odds of diabetes mainly in the younger age group. The prevalence of major depressive disorder was significantly higher among those with diabetes and ACEs than those with diabetes alone (3.7% and 0.3% respectively).ConclusionsEfforts to promote regular exercise and healthy lifestyles both in the population and among those with diabetes must continue for the prevention and management of diabetes. The findings emphasise the need to create more awareness of both the prevalence and impact of ACEs among those treating chronic diseases.
| S-EPMC7959232 | biostudies-literature
Project description:Adverse experiences and family income in childhood have been associated with altered brain development. While there is a large body of research examining these associations, it has primarily used cross-sectional data sources and studied adverse experiences and family income in isolation. However, it is possible that low family income and adverse experiences represent dissociable and potentially interacting profiles of risk. To address this gap in the literature, we examined brain structure as a function of adverse experiences in childhood and family income in 158 youths with up to five waves of MRI data. Specifically, we assessed the interactive effect of these two risk factors on six regions of interest: hippocampus, putamen, amygdala, nucleus accumbens, caudate, and thalamus. Adverse experiences and family income interacted to predict putamen volume (B = 0.086, p = 0.011) but only in participants with family income one standard deviation below the mean (slope estimate = -0.11, p = 0.03). These results suggest that adverse experiences in childhood result in distinct patterns of brain development across the socioeconomic gradient. Given previous findings implicating the role of the putamen in psychopathology-related behaviors, these results emphasize the importance of considering life events and socioeconomic context when evaluating markers of risk. Future research should include interactive effects of environmental exposures and family income to better characterize risk for psychopathology in diverse samples.
| S-EPMC10038819 | biostudies-literature
Project description:Adverse childhood experiences (ACEs) have been linked to early sexual debut, which has been found to be associated with multiple adverse health outcomes. Sexual minorities and men tend to have earlier sexual debut compared to heterosexual populations and women, respectively. However, studies examining the association between ACEs and early sexual debut among men and sexual minorities are lacking. The aim of this study was to examine the sex and sexual orientation disparities in the association between ACEs and age at sexual debut. Data were obtained from Wave 2 of the National Epidemiologic Survey on Alcohol and Related Conditions. Logistic and linear regression models were used to obtain crude and adjusted estimates and 95% confidence intervals adjusting for age, race/ethnicity, income, education, insurance and marital status for the association between ACEs (neglect, physical/psychological abuse, sexual abuse, parental violence, and parental incarceration and psychopathology) and early sexual debut. Analyses were stratified by sex and sexual orientation. Larger effect estimates depicting the association between ACEs and sexual debut were seen for women compared to men, and among sexual minorities, particularly among men who have sex with men (MSM) and women who have sex with women (WSW), compared to heterosexuals. Sexual health education programs with a focus on delaying sexual debut among children and adolescents should also consider addressing ACEs, such as neglect, physical, psychological and sexual abuse, witnessing parental violence, and parental incarceration and psychopathology. Public health practitioners, researchers and sexual health education curriculum coordinators should consider these differences by sex and sexual orientation when designing these programs.
| S-EPMC4527947 | biostudies-literature
Project description:BackgroundAdverse childhood experiences (ACEs), such as abuse, household dysfunction, and neglect, have been shown to increase adults' risk of developing chronic conditions and risk factors for chronic conditions, including cardiovascular disease (CVD). Much less work has investigated the effect of ACEs on children's physical health status that may lead to adult chronic health conditions. Therefore, the present study examined the relationship between ACEs and early childhood risk factors for adult cardiovascular disease.Methods1 234 grade six to eight students participated in school-based data collection, which included resting measures of blood pressure (BP), heart rate (HR), body mass index (BMI) and waist circumference (WC). Parents of these children completed an inventory of ACEs taken from the Childhood Trust Events Survey. Linear regression models were used to assess the relationship between experiencing more than 4 ACEs experienced, systolic BP, HR, BMI and WC. In additional analysis, ACEs were assessed ordinally in their relationship with systolic BP, HR, and BMI as well as clinical obesity and hypertension status.ResultsAfter adjustment for family education, income, age, sex, physical activity, and parental history of hypertension, and WC for HR models, four or more ACEs had a significant effect on HR (b = 1.8 bpm, 95% CI (0.1-3.6)) BMI (b =1.1 kg/m2, 95% CI (0.5-1.8)), and WC (b = 3.6 cm, 95% CI (1.8-5.3)). A dose-response relationship between ACE accumulation and both BMI and WC was also found to be significant. Furthermore, accumulation of 4 or more ACEs was significantly associated with clinical obesity (95th percentile), after controlling for the aforementioned covariates.ConclusionsIn a community sample of grade six to eight children, accumulation of 4 or more ACEs significantly increased BMI, WC and resting HR. Therefore, risk factors related to reported associations between ACEs and cardiovascular outcomes among adults are identifiable in childhood suggesting earlier interventions to reduce CVD risk are required.
| S-EPMC3878623 | biostudies-literature
Project description:HIV and other sexually transmitted infections (STIs) are important public health challenges in the US. Adverse childhood experiences (ACEs), including abuse (emotional, physical or sexual), witnessing violence among household members, may have an effect on sexual behaviors, which increase the risk of HIV/STIs. The aim of this study was to examine the sex differences in the role of posttraumatic stress disorder (PTSD), major depression (MD), substance use disorders (SUDs), early sexual debut, and intimate partner violence (IPV) perpetration as mediators in the association between ACEs and HIV/STIs. Data were obtained from Wave 2 (2004-2005) of the National Epidemiologic Survey on Alcohol and Related Conditions. Structural equation modeling was used to determine the role of PTSD, MD, SUDs, early sexual debut, and IPV perpetration as mediators in the relationships between ACEs and HIV/STIs. Differences and similarities existed in the mediational roles of psychopathology and sexual behaviors. For example, among men, MD fully mediated physical/psychological abuse (? = 0.0002; p = 0.012) and sexual abuse (? = 0.0002; p = 0.006), and HIV/STIs while among women, MD fully mediated physical/psychological abuse (? = 0.0005; p < 0.001) and parental violence (? = -0.0002; p = 0.012). Among men, IPV perpetration fully mediated sexual abuse (? = -0.0005; p = 0.012) and HIV/STIs while among women, IPV perpetration was not a statistically significant mediator. HIV/STI prevention and intervention programs should use a life course approach by addressing adverse childhood events among men and women and consider the sex differences in the roles of psychopathology and sexual behaviors.
| S-EPMC5896316 | biostudies-literature
Project description:To assess the relationships between adverse childhood experiences (ACEs) and comorbid Diagnostic and Statistical Manual of Mental Disorders, Fifth Edition (DSM-5) substance use and mental health disorders across 5 sexual orientation subgroups: lesbian/gay, bisexual, unsure, discordant heterosexual (ie, heterosexual-identified with same-sex attraction or behavior), and concordant heterosexual. Data were from the 2012-2013 National Epidemiologic Survey on Alcohol and Related Conditions-III, a cross-sectional, nationally representative survey of non-institutionalized US adults. Data were collected in households via structured diagnostic face-to-face interviews; the overall response rate was 60.1%. The sample included 36,309 US adults aged 18 years and older. Sexual minorities (gay, lesbian, bisexual), especially bisexual women, reported the highest prevalence of ACEs and comorbid substance use and mental health disorders. Approximately 43.8% of bisexual women reported 4 or more ACEs, and 38.0% of bisexual women reported comorbid substance use and mental health disorders. Multivariable regression analyses indicated a curvilinear relationship between ACEs and comorbid substance use and mental health disorders, and sexual minorities consistently had a higher ACE mean than concordant heterosexual respondents. The majority of sexual minorities with high levels of ACEs had comorbid substance use and mental health disorders. Sexual minorities are exposed to more ACEs than their heterosexual counterparts in the US. We found evidence that US sexual minorities are at higher risk of comorbid substance use and mental health disorders. These findings reinforce the importance of identifying exposure to ACEs and developing trauma-informed interventions to treat comorbidities in those exposed to multiple ACEs, especially sexual minorities..
| S-EPMC7790524 | biostudies-literature
Project description:OBJECTIVE:The aim of the current study was to determine the association between the experiences of adolescents and their parents with paediatric diabetes care at hospital outpatient departments and the association between these experiences and the Hemoglobin A1c (HbA1c) levels of adolescents. DESIGN:Cross-sectional survey. SETTING:Paediatric diabetes care at hospital outpatient departments in Norway. PARTICIPANTS:Parents of all outpatients registered in the Norwegian Childhood Diabetes Registry and patients in the same registry aged 12-17 years. INTERVENTION:1399 parents participated in a national pilot survey and 335 patients aged 12-17 years from the four largest paediatric outpatient departments in Norway responded in another pilot study. 181 paired parental and patient questionnaires were analysed. MAIN OUTCOME MEASURES:The correlations between single items, indicator scores and overall scores were explored, as was that between indicator scores and HbA1c levels. RESULTS:There was a moderate but significant correlation between the responses of the patients and parents. For 40 of the 42 associations the correlations were significant, ranging from 0.16 to 0.42. A weak but significant negative correlation was found between the indicator scores of parents and the HbA1c levels of the adolescents. The strongest correlations were between HbA1c level and nurse contact and organisation, both with a correlation coefficient of 0.21 (p<0.01). There was no significant correlation between HbA1c level and patient indicator scores. CONCLUSIONS:These results highlight the need to obtain information from both parents and adolescents, and indicate that the views of adolescents are not always mirrored by their parents. Three of the seven parent experience indicators were significantly related to the HbA1c levels of adolescents, but replication in future research with larger sample sizes is warranted.
| S-EPMC6830699 | biostudies-literature
Project description:Events causing stress responses during sensitive periods of rapid neurological development in childhood may be early determinants of all-cause premature mortality. Using a British birth cohort study of individuals born in 1958, the relationship between adverse childhood experiences (ACE) and mortality?50 year was examined for men (n=7,816) and women (n=7,405) separately. ACE were measured using prospectively collected reports from parents and the school: no adversities (70%); one adversity (22%), two or more adversities (8%). A Cox regression model was carried out controlling for early life variables and for characteristics at 23 years. In men the risk of death was 57% higher among those who had experienced 2+ ACE compared to those with none (HR 1.57, 95% CI 1.13, 2.18, p=0.007). In women, a graded relationship was observed between ACE and mortality, the risk increasing as ACE accumulated. Women with one ACE had a 66% increased risk of death (HR 1.66, 95% CI 1.19, 2.33, p=0.003) and those with ?2 ACE had an 80% increased risk (HR 1.80, 95% CI 1.10, 2.95, p=0.020) versus those with no ACE. Given the small impact of adult life style factors on the association between ACE and premature mortality, biological embedding during sensitive periods in early development is a plausible explanatory mechanism.
| S-EPMC3787798 | biostudies-other
Project description:To report total fluid intake (TFI) and the intake of different fluid types in adults (??18 years old) from Mexico, Argentina, Brazil and Uruguay. To compare intakes between countries and with recommended adequate intake (AI) of water from fluids.Cross-sectional data were collected using a validated liquid intake 7-day record (Liq.In 7 ) in populations from Argentina (n?=?1089), Brazil (n?=?477), Mexico (n?=?1677) and Uruguay (n?=?554). Population characteristics, including age, gender, body mass index and socioeconomic level were recorded. Mean TFI was compared with the AI of water from fluids set by the USA Institute of Medicine.The lowest TFI was recorded in Mexican women (1748 mL/day) and the highest in Argentinean men (2318 mL/day). Median daily TFI was significantly different between countries; Uruguay and Argentina had higher values than Mexico and Brazil. In the former, plain water contributed to only 25% of TFI, the remainder being predominantly from hot beverages. Approximately, a third of adults did not drink enough fluid to meet the recommended AI. High SSB consumption was reported, which was significantly different between countries (p?<?0.05), the highest being in Mexico (median 25-75th percentiles): 531 (300-895 mL/day.This survey highlights the need to increase water consumption and reduce SSB intake in this region to avoid potential associated health risks. These findings may be useful information in monitoring public health policy strategies.
| S-EPMC6008364 | biostudies-other