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ACEs Research Corner — November 2020


[Editor's note: Dr. Harise Stein at Stanford University edits a web site -- -- that focuses on the health effects of abuse, and includes research articles on ACEs. Every month, she posts  the summaries of the abstracts and links to research articles that address only ACEs. Thank you, Harise!! -- Jane Stevens]

Campbell KA, Gamarra E, Frost CJ, Choi B, Keenan HT.
Childhood Adversity and Health After Physical Abuse. Pediatrics. 2020 Oct;146(4):e20200638. PMID: 32938778
From surveys of 178 caregivers of children 2-12 years with a CPS finding of physical abuse, mean ACE exposure was 5.5. Each ACE reduced psychosocial health-related quality of life.

Groenewald CB, Murray CB, Palermo TM.
Adverse childhood experiences and chronic pain among children and adolescents in the United States. Pain Rep. 2020 Aug 13;5(5):e839. PMID: 32903388
From a large national survey of children aged 6 to 17 years, 49.8% were exposed to one or more ACEs during their lifetimes. Having 1+ ACE was associated with higher rates of chronic pain (8.7% vs. 4.8% without ACEs). The strongest associated ACEs for children with chronic pain included financial instability, living with a mentally ill adult, and having experienced racial discrimination.

Crouch E, Radcliff E, Hung P, Bennett K.
Challenges to School Success and the Role of Adverse Childhood Experiences. Acad Pediatr. 2019 Nov-Dec;19(8):899-907. PMID: 31401231
From a national survey, ACEs impacted multiple measures of school success. “Children with 4 or more ACEs had higher odds of nonengagement in school (adjusted odds ratio 2.15), reported school absenteeism (aOR 1.75), and of repeating a grade (aOR 1.71) than children with exposure to less than 4 ACEs.”

Giano Z, Wheeler DL, Hubach RD.
The frequencies and disparities of adverse childhood experiences in the U.S. BMC Public Health. 2020 Sep 10;20(1):1327. PMID: 32907569
Using adult data from 34 states, 57.8% reported experiencing at least one ACE, with 21.5% experiencing 3+ ACEs. Groups that had significantly higher scores were females, multiracial individuals, and sexual minority individuals, especially bisexual. Groups with lower scores included White and those with higher income/educational attainment.

Sheridan MA, Shi F, Miller AB, Salhi C, McLaughlin KA.
Network structure reveals clusters of associations between childhood adversities and development outcomes. Dev Sci. 2020 Sep;23(5):e12934. PMID: 31869484
In looking at the connection between childhood maltreatment exposures and outcomes, rather than examining the consequences of adversity exposure as a model of cumulative risk, authors introduce the concept of reorganizing adversity into two separate clusters – a deprivation and a threat cluster.

Lorenc T, Lester S, Sutcliffe K, Stansfield C, Thomas J.
Interventions to support people exposed to adverse childhood experiences. BMC Public Health. 2020 May 12;20(1):657. PMID: 32397975
From a review of reviews, “There are significant gaps in the evidence on interventions for ACEs. Most approaches focus on mitigating individual psychological harms, and do not address the social pathways which may mediate the negative impacts of ACEs. Many negative impacts of ACEs (e.g. on health behaviours, social relationships and life circumstances) have also not been widely addressed by intervention studies.”

Lester S, Khatwa M, Sutcliffe K.
Service needs of young people affected by adverse childhood experiences (ACEs): A systematic review of UK qualitative evidence. Child Youth Serv Rev. 2020 Nov;118:105429. PMID: 32895586
From a research review, young people affected by ACEs “described the importance of stability and continuity in the support they receive…Service providers were most valued for displaying empathy, being non-judgmental, and being active listeners…These factors are important for allowing necessary time to overcome obstacles and build up trust. Research often frames response to ACE in terms of short term individual psychological outcomes but these findings highlight the importance of focusing on wider social factors to encourage meaningful engagement with services.”

Wang YR, Sun JW, Lin PZ, Zhang HH, Mu GX, Cao FL.
Suicidality among young adults: Unique and cumulative roles of 14 different adverse childhood experiences. Child Abuse Negl. 2019 Dec;98:104183. PMID: 31521907
From a survey of 989 Chinese college students, “The rates of suicidal ideation [SI], plans, and attempts among the cohort were 11.9%, 3.7%, and 1.6%, respectively; 43.9% had experienced at least one ACE. The strongest predictor of SI was peer isolation/rejection, followed by emotional neglect, then low socioeconomic status. There was a cumulative effect of ACEs and SI.”

Bettis AH, Thompson EC, Burke TA, et. al.
Prevalence and clinical indices of risk for sexual and gender minority youth in an adolescent inpatient sample. J Psychiatr Res. 2020 Nov;130:327-332. PMID: 32877826
Of 515 adolescents admitted to a psychiatric inpatient unit due to being considered a danger to self or others, and controlling for current depression, nearly 40% identified as sexual and/or gender minority. Sexual minority youth reported higher rates of suicidal ideation, suicidal behavior, non-suicidal self-injury, and higher ACE scores.

Schnarrs PW, Stone AL, Salcido R Jr, et. al.
Differences in adverse childhood experiences (ACEs) and quality of physical and mental health between transgender and cisgender sexual minorities. J Psychiatr Res. 2019 Dec;119:1-6. PMID: 31518909
Of 477 sexual and gender minority individuals, “Transgender participants reported emotional abuse, physical neglect, and emotional neglect more frequently compared to cisgender LGB people…Further, there may exist unique adverse experiences among this population during childhood resulting from social stigma. Future research should identify and quantify these experiences.”

Dekel B, Andipatin M, Abrahams N.
Exploring adversities among parents convicted of killing their children. PLoS One. 2020 Jul 22;15(7):e0235812. PMID: 32697774
Interviews with 22 parents/stepparents/caregivers convicted of child homicide in South Africa revealed “widespread and cumulative nature of violence and trauma experiences within multiple domains of the participants' lives…and the absence of support in the aftermath of experiencing trauma.”

Thakur N, Hessler D, Koita K, et. al.
Pediatrics adverse childhood experiences and related life events screener (PEARLS) and health in a safety-net practice. Child Abuse Negl. 2020 Oct;108:104685. PMID: 32898839
367 participants (0-11 years) from a primary care clinic were randomized 1:1:1 to item-level ACE screening, aggregate screening (total number only) or no screening. 75% reported at least one adversity, with a median of 2. “Participants in the aggregate-level screening arm, on average, disclosed 1 additional adversity compared to item-level screening”. Higher scores were associated with poorer perceived child general health, global executive functioning, and greater odds of stomachaches and asthma.

Onigu-Otite E, Idicula S.
Introducing ACEs (Adverse Childhood Experiences) and Resilience to First-Year Medical Students. MedEdPORTAL. 2020 Sep 15;16:10964. PMID: 32964120
“This lecture fills a gap in medical curriculum education, specifically by increasing awareness of ACEs and how they relate to medical and mental health conditions, including challenges to care…a case that synthesized ACEs, chronic medical conditions, and response to treatment was high yield, was viewed as useful, and generated interest among attendees…medical practitioners should consider ACEs in difficult-to-treat cases where otherwise effective remedies have not been sufficient.” Full text, case and slides

Sanders MT, Welsh JA, Bierman KL, Heinrichs BS.
Promoting resilience: A preschool intervention enhances the adolescent adjustment of children exposed to early adversity. Sch Psychol. 2020 Sep;35(5):285-298. PMID: 32955273
Data from 294 children from low-income families recruited from Head Start classrooms to participate in a preschool intervention and followed through 9th grade showed that the REDI intervention, which focused on promoting early social-emotional and language skills, decreased the impact of early ACEs on adolescent adjustment and promoted youth resilience.

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