A review of primary care interventions to improve health outcomes in adult survivors of adverse childhood experiences

Korotana, Laurel M.; Dobson, Keith S.; Pusch, Dennis; Josephson, Trevor

doi:10.1016/j.cpr.2016.04.007

Cited by 69 publications

(47 citation statements)

References 229 publications

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“…Many with disorders are not in treatment, underscoring the importance of assessing adversity exposure along the life course, through childcare, educational, vocational, primary care and related filtering service sites to assess for needs. Use of cognitive-behavioral therapies, skill building (e.g., coping and interpersonal skills) and resilience-oriented mindfulness approaches also show considerable promise toward attenuating symptomology as well as more effective long-term stress management (Korotana, Dobson, Pusch, & Josephson, 2016). …”

Section: Discussionmentioning

confidence: 99%

Modeling life course pathways from adverse childhood experiences to adult mental health

Jones

Nurius

Song

et al. 2018

Child Abuse & Neglect

117

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Although the association between adverse childhood experiences (ACEs) and adult mental health is becoming well established, less is known about the complex and multiple pathways through which ACEs exert their influence. Growing evidence suggests that adversity early in life conveys not only early impacts, but also augments risk of stress-related life course cascades that continue to undermine health. The present study aims to test pathways of stress proliferation and stress embodiment processes linking ACEs to mental health impairment in adulthood. Data are from the 2011 Behavioral Risk Factor Surveillance Survey, a representative sample of Washington State adults ages 18 and over (N = 14,001). Structural equation modeling allowed for testing of direct and indirect effects from ACEs though low income status, experiences of adversity in adulthood, and social support. The model demonstrated that adult low income, social support and adult adversity are in fact conduits through which ACEs exert their influence on mental health impairment in adulthood. Significant indirect pathways through these variables supported hypotheses that the effect of ACEs is carried through these variables. This is among the first models that demonstrates multiple stress-related life course pathways through which early life adversity compromises adult mental health. Discussion elaborates multiple service system opportunities for intervention in early and later life to interrupt direct and indirect pathways of ACE effects.

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Section: Discussionmentioning

confidence: 99%

Modeling life course pathways from adverse childhood experiences to adult mental health

Jones

Nurius

Song

et al. 2018

Child Abuse & Neglect

117

View full text Add to dashboard Cite

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“…Cognitive fusion (the opposite of cognitive defusion) has been shown to mediate the relationships between stigma and depression, and anxiety and QoL in PwMS (Valvano et al, 2016). A systematic review of 18 studies showed preliminary support for the use of ACT for improving selfmanagement and psychological flexibility in people with a wide range of health conditions (Graham, Gouick, Krahe´ & Gillanders, 2016). However, few studies have used ACT for PwMS.…”

Section: Impact and Implicationsmentioning

confidence: 99%

Pilot evaluation of a resilience training program for people with multiple sclerosis.

Pakenham

Mawdsley

Brown

et al. 2018

Rehabilitation Psychology

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“…They are commonly treated by psychotherapy, pharmacotherapy or their combination. Yet while childhood adversities are relatively frequent among treatment-seekers (Edwards et al, 2003), their treatment implications are still unclear (Kaufman, 2012;Korotana et al, 2016). For instance, do early adversities indicate the need for more intense or longer-term treatment?…”

Section: Introductionmentioning

confidence: 99%

Associations of early childhood adversities with mental disorders, psychological functioning, and suitability for psychotherapy in adulthood

Heinonen

Knekt

Härkänen

et al. 2018

Psychiatry Research

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Childhood adversities frequently precede adulthood depression and anxiety. Yet, how they impact needed treatment duration, type or focus in these common disorders, is unclear. For developing more individualized and precise interventions, we investigated whether specific early adversities associate with patients' distinct psychiatric problems, psychological vulnerabilities, and suitability for psychotherapy. A total of 221 depressed and anxious adult outpatients (excluding psychotic, severe personality, bipolar, and substance abuse disorders) referred from community, student, occupational, and private healthcare services filled the Childhood Family Atmosphere Questionnaire (CFAQ). They also filled self-reports on interpersonal behavior and problems, perceived competence, dispositional optimism, sense of coherence, defenses, and psychiatric history. Clinicians assessed the patients' symptomatology, personality, object relations, cognitive performance, and psychotherapy suitability. Regression analyses were conducted. Childhood adversities predicted both worse current psychological functioning (e.g., interpersonal problems), and better clinician-rated capacities for benefiting from psychotherapy (e.g. self-reflection, capacity for interaction). Parental problems had the most numerous negative associations to psychological functioning. Best capacities for psychotherapy were predicted by recollected family unhappiness. Associations with psychiatric criteria were, however, largely non-significant. In conclusion, for psychosocial treatment planning, patients' early adversities may indicate both vulnerability and resources. As childhood adversities are frequent among treatment-seekers, further studies examining how early adversities predict psychotherapy outcome are needed.

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A review of primary care interventions to improve health outcomes in adult survivors of adverse childhood experiences

Cited by 69 publications

References 229 publications

Modeling life course pathways from adverse childhood experiences to adult mental health

Modeling life course pathways from adverse childhood experiences to adult mental health

Pilot evaluation of a resilience training program for people with multiple sclerosis.

Associations of early childhood adversities with mental disorders, psychological functioning, and suitability for psychotherapy in adulthood

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