Adverse childhood experiences, childhood relationships and associated substance use and mental health in young Europeans

Hughes, Karen; Bellis, Mark A; Sethi, Dinesh; Andrew, Rachel; Yon, Yongjie; Wood, Sara; Ford, Kat; Băban, Adriana; Boderscova, Larisa; Kachaeva, M.; Makaruk, Katarzyna; Marković, Mirjana; Povilaitis, Robertas; Raleva, Marija; Terzić, Nataša; Velemínský, Miloš; Włodarczyk, Joanna; Zakhozha, Victoria

doi:10.1093/eurpub/ckz037

Cited by 59 publications

(50 citation statements)

References 25 publications

(31 reference statements)

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“…These findings add to the literature on the importance of parenting in substance use prevention [ 73 , 74 ] and suggest prevention programs may benefit from incorporating parent modules focusing on parental support, monitoring, and consistency of discipline [ 32 , 55 – 57 ]. Of course, improving the parent-child relationship may be contraindicated when a parent is the source of abuse or adversity for the child, however, evidence suggests improved relationship quality with another family member can be protective against problem drinking and smoking [ 99 ]. Importantly, for ACE-exposed youth, many of the mediating and moderating factors may be inextricably linked to the adversity (e.g.…”

Section: Discussionmentioning

confidence: 99%

Targets for intervention to prevent substance use in young people exposed to childhood adversity: A systematic review

et al. 2021

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Background and aims Childhood adversity is a strong, and concerningly prevalent, risk factor for the later development of substance misuse. Yet despite substantial accumulating evidence for causal mechanisms, there has been little attempt to synthesize the strength of the evidence. Importantly, these mechanisms may be amenable to intervention, providing targets for substance use prevention among those exposed to childhood adversity. The present review aimed to systematically identify mediating and moderating mechanisms operating between childhood adversity and substance use. Methods A systematic review was conducted. Electronic databases (PubMed, MEDLINE, PsycINFO, Web of Science and CINAHL) were searched from 1998 to 2020 for modifiable mediators and moderators of the relationship between childhood adversity and substance use in people aged 10–24. Data was qualitatively synthesised, using a socio-ecological perspective to group mediators/moderators into individual, interpersonal, community, and public policy/cultural levels of behaviour. Results After screening against eligibility criteria, 50 studies were included in the current review. The mediators at the individual level of behaviour showing the largest and most consistent effect sizes included externalising behaviour, anger, coping motives for substance use, and post-traumatic stress symptoms. Among individual-level moderators, religiosity, future orientation and depressive symptoms all attenuated the relationship between childhood adversity and substance use. At the interpersonal level, peer relationships and mother-child relationships mediated the effect of adversity on substance use. Moderators included family cohesion and relationship quality. Community factors were less commonly studied, though school mobility and educational achievement mediated 14% and 28% of the total effect of childhood adversity on substance use respectively. No mediators or moderators were identified for public policy/culture. Conclusions A substantial proportion of the relationship between childhood adversity and substance use in youth is mediated through individual, interpersonal and community factors. Coupled with the knowledge that existing, evidence-based programs effectively address many of the identified mediators and moderators, this review advances knowledge on optimal targets to prevent substance misuse among those exposed to childhood adversity.

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Section: Discussionmentioning

confidence: 99%

Targets for intervention to prevent substance use in young people exposed to childhood adversity: A systematic review

et al. 2021

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“…The remaining family dysfunction category required dichotomous responses of 0 'No' or 1 'Yes'. As per previous research, a total number of ACEs was obtained by summing the 10 dichotomous responses (range = 0-10), and the number of ACEs was categorised into 1, 2, 3, 4, 5 or more (Carvalho et al, 2019;Gomis-Pomares & Villanueva, 2020), as well as categorised into whether the participant had experienced at least one ACE (Dube et al, 2003;Hughes et al, 2019). The ACEs questionnaire has demonstrated acceptable internal consistency and test-retest reliability in a variety of samples including young adults (Ford et al, 2014;Mersky, Janczewski, & Topitzes, 2017;Zanotti et al, 2018).…”

Section: Adverse Childhood Experiences Questionnairementioning

confidence: 99%

Early trauma and associations with altruistic attitudes and behaviours among young adults

Prior

Carvalheiro

Lawler

et al. 2021

Child Abuse & Neglect

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Background: Childhood and adolescent traumas are exceptionally prevalent worldwide. Despite their high prevalence and substantial impact, little research has investigated the rates and specific types of early trauma by gender. It is also unknown whether the types of early trauma are differentially associated with heightened or hindered prosocial attitudes and behaviours. Objective: To address this gap, this study aims to explore the rates of different types of early trauma (i.e., abuse: sexual, physical, and emotional; neglect: physical and emotional) among young Australian adults and investigate whether these differ according to participant gender (female, male and transgender/gender diverse). The study will also examine the associations between the different types of early trauma and current altruistic attitudes and behaviours (including the affective, behavioural and cognitive altruism domains), among a young adult Australian cohort. Methods: Cross-sectional data was collected from 511 young Australians aged 18-20 years using an online self-report survey. Results: Multiple regression analyses revealed that transgender/gender diverse individuals were over 3-times more likely to experience all types of maltreatment than females and over 3-times more likely to experience emotional and sexual abuse and emotional neglect than males. Experiencing one or more trauma types was negatively associated with the cognitive domain of altruism, experiencing physical neglect was associated with the affective domain, and having a family member involved in domestic violence was associated with the behavioural domain, after controlling for gender. Conclusions: Findings show how early traumatic experiences can influence individuals' attitudes and behaviours during the pivotal developmental period of young adulthood.

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“…[12][13][14][15] Studies also show that most individuals who report having suffered any specific ACE type (eg, physical abuse) also report other ACE types. 16 Consequently, prevention efforts focused on any individual ACE type are likely to have limited success if the range of other ACEs affecting families are left unaddressed. The rapid proliferation of awareness on the impacts of ACEs on the policy priorities of different sectors is driving multiagency action to enhance early intervention and develop trauma-informed services.…”

Section: Open Accessmentioning

confidence: 99%

Health and financial burden of adverse childhood experiences in England and Wales: a combined primary data study of five surveys

et al. 2020

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ObjectiveTo estimate the health and financial burden of adverse childhood experiences (ACEs) in England and Wales.DesignThe study combined data from five randomly stratified cross-sectional ACE studies. Population attributable fractions (PAFs) were calculated for major health risks and causes of ill health and applied to disability adjusted life years (DALYs), with financial costs estimated using a modified human capital method.SettingHouseholds in England and Wales.Participants15 285 residents aged 18–69.Outcome measuresThe outcome measures were PAFs for single (1 ACE) and multiple (2–3 and ≥4 ACEs) ACE exposure categories for four health risks (smoking, alcohol use, drug use, high body mass index) and nine causes of ill health (cancer, type 2 diabetes, heart disease, respiratory disease, stroke, violence, anxiety, depression, other mental illness); and annual estimated DALYs and financial costs attributable to ACEs.ResultsCumulative relationships were found between ACEs and risks of all outcomes. For health risks, PAFs for ACEs were highest for drug use (Wales 58.8%, England 52.6%), although ACE-attributable smoking had the highest estimated costs (England and Wales, £7.8 billion). For causes of ill health, PAFs for ACEs were highest for violence (Wales 48.9%, England 43.4%) and mental illness (ranging from 29.1% for anxiety in England to 49.7% for other mental illness in Wales). The greatest ACE-attributable costs were for mental illness (anxiety, depression and other mental illness; England and Wales, £11.2 billion) and cancer (£7.9 billion). Across all outcomes, the total annual ACE-attributable cost was estimated at £42.8 billion. The majority of costs related to exposures to multiple rather than a single ACE (ranging from 71.9% for high body mass index to 98.3% for cancer).ConclusionsACEs impose a substantial societal burden in England and Wales. Policies and practices that prevent ACEs, build resilience and develop trauma-informed services are needed to reduce burden of disease and avoidable service use and financial costs across health and other sectors.

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Adverse childhood experiences, childhood relationships and associated substance use and mental health in young Europeans

Cited by 59 publications

References 25 publications

Targets for intervention to prevent substance use in young people exposed to childhood adversity: A systematic review

Targets for intervention to prevent substance use in young people exposed to childhood adversity: A systematic review

Early trauma and associations with altruistic attitudes and behaviours among young adults

Health and financial burden of adverse childhood experiences in England and Wales: a combined primary data study of five surveys

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