Search Results (487)

Adverse childhood experiences (ACEs) have been associated with increased vulnerability to depressive symptoms during pregnancy and may also be related to emerging prenatal relational processes. This cross-sectional study examined whether prenatal depressive symptoms statistically accounted for the association between ACEs and maternal–fetal attachment (MFA), and whether this indirect association varied as a function of perceived social support from partners, family, and friends. The sample included 149 Romanian women in the first trimester of their first pregnancy. Participants completed self-report measures assessing ACEs, prenatal depressive symptoms, MFA, and perceived social support. Conditional process analyses were conducted using PROCESS Model 7, controlling for maternal age and perceived socioeconomic status. Higher ACEs were significantly associated with increased prenatal depressive symptoms (b = 0.43, p = 0.001), which in turn were associated with lower MFA (b = −0.03, p = 0.023). The indirect association between ACEs and MFA via prenatal depressive symptoms was statistically significant (b = −0.01, 95% CI [−0.028, −0.0009]). However, perceived social support from partners, family, and friends did not significantly moderate this indirect association. These findings provide preliminary evidence that prenatal depressive symptoms represent an important psychological correlate linking early-life adversity with lower MFA in early pregnancy. Given the cross-sectional design, findings should be interpreted as indirect associations rather than causal mediation. Full article

Previous research has shown that adverse childhood experiences, such as harsh parenting or corporal punishment, can have long-lasting effects on individuals’ psychological well-being. Still, little is known about how these effects interact with cultural and structural factors in non-Western contexts. Drawing on data from an original 2020 survey of 1087 married women in Beijing, linear regression analysis reveals that women who experienced childhood harsh parenting report significantly lower levels of self-esteem than those who did not. Surprisingly, this negative association is amplified at higher levels of educational attainment. Further analysis also shows that the negative association between childhood harsh parenting and self-esteem is stronger among women who reported having greater autonomy in mate choice for marriage than among those with limited autonomy. The findings suggest that while educational attainment and autonomy in mate choice for marriage are typically associated with empowerment, they may also intensify reflexivity, temporal comparisons, and heightened role expectations. These dynamics can reactivate early experiences of harsh parenting, exacerbating the influence of unresolved childhood trauma on adult self-esteem. Full article

This paper interrogates exclusionary discipline as a carceral practice for Black girls disproportionately exposed to adverse childhood experiences (ACEs) in Tennessee. Using 2017–2018 data from the Office for Civil Rights and the National Survey of Children’s Health, we describe girls’ risk for suspensions, access to school support staff, and girls’ exposure to nine types of ACEs. Findings show Black girls in Tennessee had 4.22 times the risk of receiving a single out-of-school suspension and had 2.28 times the risk of being arrested compared to all other girls. Black girls in TN also had a higher risk for six out of nine ACEs, with a statistically significant ACE of parental divorce. We posit that the disproportional discipline and ACEs that Black girls experience are rooted in structural inequities that undergird the abuse-to-prison pipeline. We suggest that eradicating the adversity-to-prison pipeline requires schools to view ACEs as systemic harm, not personal deficits, and adopt intersectional, healing-focused reforms led by school social workers. Full article

Parental divorce, as an adverse childhood experience, may disrupt family systems and exert enduring effects on psychological development, with impacts becoming particularly salient during emerging adulthood, a stage characterized by identity exploration and increasing autonomy. Within the Thai cultural context, inner strengths grounded in Buddhist values may serve as important resources for resilience. This study examined associations between inner strength dimensions derived from the Ten Perfections (Pāramīs) and resilience among emerging adults who experienced parental divorce in childhood. A cross-sectional design was employed with 160 Thai participants aged 20 to 29 years, who completed the Inner Strength-Based Inventory (I-SBI) and the Resilience Inventory (RI-9). Correlation analysis indicated that equanimity, determination, perseverance, wisdom, meditation, and loving-kindness were positively correlated with resilience. Multiple regression analysis showed that equanimity (β = 0.312, p < 0.001), determination (β = 0.227, p < 0.01) and loving-kindness (β = 0.213, p < 0.01) were significantly associated with resilience. These findings suggest that culturally embedded inner strengths are associated with resilience in a non-Western context. More specifically, among the ten dimensions examined, equanimity, determination, and loving-kindness emerged as being significantly associated with resilience in Thai emerging adults with childhood parental divorce experiences. Full article

Background: The negative impact of adverse childhood experiences (ACEs) on child development is documented. The parent–child relationship protects against ACEs and improves healthy child development, playing a crucial role in preventing and mitigating ACEs by strengthening parental resilience. However, there is a gap in the literature on our understanding of parental resilience’s impact on the parent–child relationship within the social–ecological model (SEM) (i.e., intra- and interpersonal, community, and societal levels). Objective: This study explores parents’ perspectives on parental resilience as a protective factor for preventing and mitigating ACEs at every level of the SEM. Method: This study uses a thematic analysis approach for qualitative research. In-depth individual interviews (n = 21) were conducted with members of a parent support group (PSG) (85% female) based in a community-based organization serving families. Demographic information and ACE scores were collected for each participant to describe the sample. Results: Key findings highlighted parents’ perspectives on improved resilience through self-regulation and social support following participation in PSGs, conceptualized as an inter-level construct within the SEM mechanism due to its influence on parents’ well-being, traversing SEM levels. Under Theme 1: The Many Faces of Parental Resilience, Theme 3: The Power of Close Relationships, Theme 4: Community Resources as a Buffer, and Theme 7: Change Through a Policy Lens: “Anything that protects them,” parents expressed a strong desire for ACE prevention and mitigation strategies and called for systemic policy change to combat ACEs. Conclusions: Parental resilience perceptions are valuable and hold promise to inform the future institutionalization of a multi-level parent resilience-focused framework, which will aid in ACE prevention and mitigation. Full article

Adverse Childhood Experiences (ACEs), which encompass a broad range of adverse events during childhood, are prevalent in rural China. However, help-seeking among adults with ACEs remains limited and underexplored. This study aims to examine the barriers to help-seeking behaviors among adults with ACEs in rural China. Qualitative interviews were conducted with 20 adults affected by ACEs in rural mainland China between October 2024 and December 2024. Data were collected through semi-structured interviews in Mandarin, and transcripts were analyzed using the Theory of Planned Behavior (TPB) framework, focusing on behavioral beliefs, normative beliefs, and perceived behavioral control. The findings reveal barriers to help-seeking among individuals with ACEs in rural China, categorized into three key dimensions: (1) Behavioral Beliefs: Beliefs that corporal punishment is the responsibility as well as love of parents, and misconceptions attributing ACEs to personal faults significantly hindered help-seeking. (2) Normative Beliefs: Respect for parental authority in China culture context hinder help-seeking for adults with ACEs. Moreover, gender differences were evident, with men avoiding help-seeking due to perceived shame, while women were more likely to confide in friends and family. Finally, stigmatization of mental health services further inhibited help-seeking behaviors. (3) Perceived Behavioral Control: The lack of formal and informal support systems in rural areas exacerbated the issue, highlighting significant gaps in resource accessibility and cultural acceptance of mental health support. Addressing these barriers through public education, destigmatization of mental health services, and improved resource allocation could facilitate help-seeking behaviors and improve outcomes for individuals affected by ACEs. Full article

Psychological constructs such as anxiety, depression, fatalism subscales—fatalism, divine control, luck, helplessness, and internality—play an important role in shaping mental health outcomes in the United States (US). Although several studies have explored how specific variables correlate with these constructs, less is known about how sociodemographic and experiential factors interact to shape multidimensional fatalism, including the subscales of fatalism, divine control, luck, helplessness and internality. This study addresses the gap by using Conditional Inference Trees (CITs) to explore how interactions among variables are associated with these constructs. Using the Conditional Inference Tree (CIT) analyses, we examined how Adverse Childhood Experience (ACE), age, gender, race, education, and urbanicity are associated with depression, anxiety, and fatalism subscales. Our analyses revealed that ACE and age were the most significant variables associated with depression and anxiety, with higher ACE scores associated with higher levels of both depression and anxiety. For multidimensional fatalism, age, race, gender, and urbanicity were key variables, although their effects varied across subscales. Overall, these findings highlight the importance of considering interaction effects when examining mental health outcomes and fatalistic belief systems. CIT analysis provides a useful explanatory framework for identifying complex patterns of association between early life adversity, sociodemographic factors and psychological constructs. Full article

People have become accustomed to studying or working with the guidance of artificial intelligence (AI) in recent years. Studies have begun investigating the risk factors of AI dependence, though most have used hypothesis-testing methods. The present study aimed to investigate predictors of AI dependence using machine-learning and network analysis, which are data-driven approaches. The included risk factors were Big Five personality traits, self-efficacy, depression, social anxiety, adverse childhood experiences, and AI use motivation, selected based on theories and empirical studies. Participants consisted of 1258 university students (942 females and 316 males) with a mean age of 22.11 years (SD = 2.69). Four machine-learning algorithms were tested, including Elastic Net, Random Forest, XGBoost, and LightGBM. Machine-learning results indicate that escape and social motivation for AI use, along with social anxiety, were the main predictors of AI dependence. Network analysis results show that escape and social motivation were the most central nodes, with the highest Expected Influence (EI) indices. This study indicates that when addressing mental health problems related to AI dependence, it is more effective to focus on emotional isolation and social interaction challenges rather than simply cutting down on AI use. Full article

Legal advocacy for parents involved in the public child welfare system in the United States is typically initiated only after a child has been removed and a dependency petition has been filed. For infants, removal at or shortly after birth constitutes a profound disruption of the parent–child attachment relationship and is increasingly recognized as an adverse childhood experience. This paper focuses on a summative program evaluation of the Family Intervention Response to Stop Trauma (FIRST) Legal Clinic in Washington State, a prevention-oriented model providing free, confidential legal advocacy and peer support to pregnant and postpartum parents prior to Child Protective Services (CPS) investigation or court involvement. Administrative data from 2019 to 2025 for 1232 eligible families were utilized to examine eligibility and referral patterns, reasons for ineligibility, and case outcomes. Findings demonstrated that eligible families with known outcomes avoided dependency court involvement entirely or experienced case closure without child removal, while a smaller proportion proceeded to dependency court filings. These findings highlight the need to reduce unnecessary child welfare system entry and mitigate traumatic disruption of the parent–child attachment relationship at birth by providing legal advocacy before investigation and court involvement. Full article

We examine relationships across two focal variables, being an immigrant and experiencing racial discrimination (an adverse childhood experience, or ACE), and the outcome of a mental or emotional health condition for adolescent children in the U.S. Using a nationally representative sample from the National Survey of Children’s Health (NSCH; n = 16,040; 12–17 years old), we find that immigrant teens are 17 percent less likely than native-born teens to have a mental or emotional health condition and that teens who have experienced racial discrimination are almost twice as likely as teens who did not to have a mental or emotional health condition, net of other relationships. Adolescents with a mental or emotional health condition are more likely to be female, White, urban, living in an unsafe neighborhood, having a parent with less education, and coming from a household with a lower income. We find evidence for the healthy immigrant effect in terms of mental health for immigrant teens in the U.S., and also, we find a strong relationship between the ACE of experiencing racial discrimination and poor mental health of adolescents overall. Full article

Background: Young adult sexual minority men (SMM) disproportionately experience childhood interpersonal trauma. The Dimensional Model of Adversity and Psychopathology (DMAP) framework proposes that exposure to threat (i.e., emotional, physical, and sexual abuse) and deprivation (e.g., physical and emotional neglect) are differentially linked to adult psychopathology. Studies of predominantly heterosexual samples have revealed emotion regulation and mindfulness as mechanisms linking childhood trauma to mental health and health risk behaviors in adulthood. However, the influence of emotion regulation (ER) or mindfulness as associated with exposure to threat vs. deprivation has not been examined among SMM in adulthood. Objective: This study explored the relationships between childhood threat/deprivation and mental health and health risk behaviors among SMM with ER and mindfulness as mediators. Participants and Setting: The sample consisted of 317 SMM (M_age = 26.70; SD = 3.87; ages 18–35; 59.3% White) recruited from the community. Methods: Childhood experiences of threat and deprivation were assessed via the Childhood Trauma Questionnaire; ER difficulties and dispositional mindfulness were assessed using self-report. Mental health behaviors were assessed using a composite score consisting of self-reported depressive, anxiety, PTSD symptoms, and suicidality. Health risk behavior score included the Sexual Compulsivity Scale, Alcohol Use Disorders Identification Test, and smoking history (Y/N). Results: Threat and deprivation were both positively correlated with mental health and health risk behaviors. Threat was associated with both mental health and health risk behaviors via emotion regulation (ER) difficulties. Deprivation was associated with these outcomes through both ER difficulties and mindfulness. Conclusions: Treatment aimed at bolstering ER and mindfulness skills among those with histories of abuse and deprivation, respectively, may help reduce psychopathology risk among SMM. Full article

Background/Objectives: Adolescents admitted for emergency psychiatric hospitalization frequently present with severe and heterogeneous psychopathology. In clinical practice, some adolescent inpatients appear to present a broader symptom pattern suggestive of emotional dysregulation. However, it remains unclear whether they can truly be distinguished in this population and whether they differ meaningfully from adolescents with predominantly depressive presentations. Methods: We conducted a retrospective cross-sectional chart review with subgroup analysis based on the medical records of patients aged 11–17 years hospitalized on an emergency basis at the Department of Child and Adolescent Psychiatry in Poznań, Poland, between January and December 2024. Patients were assigned either to an emotional dysregulation group, defined by affective dysregulation and behavioral dyscontrol, or to a depressive presentations group, comprising adolescents with depressive presentations who did not meet criteria for the emotional dysregulation profile. Broader clinical characteristics, adverse childhood experiences, and prior treatment history were compared between groups. Results: A total of 139 adolescents were included (85 in the emotional dysregulation group and 54 in the depressive presentations group). The median age was 13 years [Q1–Q3: 13–14] in the emotional dysregulation group and 14 years [Q1–Q3: 12.25–14] in the depressive presentations group; girls comprised 77.6% and 83.3% of the groups, respectively. The emotional dysregulation group more often presented with conflict-ridden relationships, a more frequent history of suicide attempts (72.9% vs. 50.0%, p = 0.006), and a higher number of suicide attempts (median 1 [Q1–Q3: 0–2] vs. 0.5 [Q1–Q3: 0–1], p = 0.012), as well as more frequent exposure to adversity-related experiences. Furthermore, this group had a higher number of previous psychiatric hospitalizations (median 1 [Q1–Q3: 1–2] vs. 1 [Q1–Q3: 1–1], p = 0.001) and a longer history of psychiatric treatment. In contrast, social withdrawal was more characteristic of the depressive presentations group. Conclusions: Routinely collected clinical records may capture a clinically meaningful subgroup of adolescents with a symptom profile suggestive of emotional dysregulation. Compared with the depressive presentations group, these adolescents showed greater interpersonal difficulties, more recurrent suicide attempts, greater adversity burden, and a longer history of psychiatric treatment. Further prospective studies using standardized measures are needed. Full article

Non-medical use of cannabis (NmC) and/or opioids (NmO) can lead to adverse health effects (AHEs), yet the proportion of these harms attributable to adverse childhood experiences (ACEs) remains unclear. This study estimated the contribution of ACEs to AHEs from NmC and/or NmO among adults aged ≥18 years using 2019–2020 Behavioral Risk Factor Surveillance System data from Arizona and Massachusetts. We conducted a retrospective cohort analysis of 24,739 respondents, linking past ACE exposure to self-reported NmC/NmO/NmC&NmO and related AHEs. Generalized linear models with a log link and binomial distribution adjusted for socio-demographic, healthcare access, and geographic factors were used to estimate associations and population-attributable fractions (PAFs). Propensity score methods matched respondents with and without ACEs on demographic and location characteristics. Among all the adults, 17.9% reported NmC, 5.8% reported NmO, and 2.4% reported NmC&NmO; among users of NmC/NmO/NmC&NmO, 5.0%/13.2%/36.0% reported AHEs. Among the respondents reporting AHEs from non-medical substance use, exposure to ≥2 ACEs was common (NmC: 89%; NmO: 82%; NmC&NmO: 84%). Compared to adults without ACEs, those with ≥2 ACEs had a higher likelihood of AHEs for NmC (adjusted relative risk [aRR] = 3.54, 95% CI: 1.65–7.59) and NmO (aRR = 3.64, 95% CI: 1.99–6.66) but not NmC&NmO (aRR: 1.86, 95% CI: 0.84–4.09). PAFs indicated that 63% (NmC) to 64% (NmO) of AHEs among the adults reporting NmC or NmO were attributable to ≥2 ACEs. Preventing childhood adversity may substantially reduce substance-related harms in adulthood. Full article

The objective of this state-of-the-art review was to ascertain whether bullying should be regarded as an ACE. To that end, a systematic search of the extant literature was conducted. A comprehensive search of three databases yielded 27 studies that met the inclusion criteria. The papers that were identified were sorted into the following categories: expanded ACE, associations between ACEs and bullying, latent class analysis, biological stress markers and negative health outcomes associated with ACEs and bullying. The extant evidence indicates that bullying falls within the ambit of the ACE concept. Moreover, bullying contributes independently and as part of the cumulative score to the prediction of negative health outcomes. However, minor discrepancies to other ACEs were identified, for example in the different path of embodiment regarding changes in BMI. It is recommended that subsequent studies incorporate bullying as an element of their ACE measurements. One approach to doing so would be to utilize the ACE-IQ. Further research is necessary to elucidate the embodiment of the consequences of ACEs and bullying. Full article

Background: Childhood cancer survivors commonly experience long-term treatment effects that impair physical function. Access to in-person physical fitness assessments is often limited by geographic, logistical, and resource constraints. Virtually supervised physical fitness assessments may offer a feasible alternative; however, evidence in this population remains limited. Methods: This study evaluated the feasibility of delivering virtually supervised physical fitness assessments via videoconference for children and adolescents aged 5–18 years following completion of cancer treatment. Assessments evaluated lower-body strength (30 s sit-to-stand), upper-body strength (30 s push-up), mobility (timed up-and-go), balance (single-leg balance), aerobic endurance (two-minute step), and flexibility (sit-and-reach). Pre-defined feasibility benchmarks included recruitment (≥15 participants within three months), assessment completion (≥85% of participants completing all six assessments), individual assessment completion (≥90% of planned assessments completed), technique fidelity (≥85% of assessments performed with correct technique), session duration (≥90% of sessions completed in ≤30 min), safety (no adverse events), and participant satisfaction (qualitative feedback). Results: Twenty-nine participants were enrolled, with 28 completing the virtual assessments. The sample (61% male) had a mean age of 9.8 ± 3.7 years (range 5–16), with acute lymphoblastic leukaemia the most common diagnosis (46%). Recruitment exceeded benchmarks (23 participants within three months). Assessment completion was 92.9% (26/28), individual assessment completion was 98.8% (166/168), and technique fidelity was 90.9%, with the lowest fidelity for push-ups (73.1%). Most sessions were completed within 30 min (92.9%; median 19.5 min, range 15–33). No adverse events occurred. Feedback indicated high satisfaction, highlighting convenience, engagement, and practicality. Conclusions: Virtually supervised physical fitness assessments were feasible, safe, and acceptable for childhood cancer survivors. These findings provide initial feasibility evidence to support further validation and implementation research before broader clinical application. Full article