Adverse childhood experiences, family functioning and adolescent health and emotional well-being

Balistreri, Kelly Stamper; Alvira-Hammond, Marta

doi:10.1016/j.puhe.2015.10.034

Cited by 142 publications

(92 citation statements)

References 30 publications

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“…Since the influential ACE study, researchers have made great advancements in understanding the relationship between ACEs and health outcomes in adults . More recent research has begun exploring how current experiences of ACEs relate to current health challenges among children and youth . However, less is known about which ACEs are most salient in their association with health outcomes in young, vulnerable populations.…”

Section: Introductionmentioning

confidence: 99%

“…[8][9][10] More recent research has begun exploring how current experiences of ACEs relate to current health challenges among children and youth. [11][12][13][14] However, less is known about which ACEs are most salient in their association with health outcomes in young, vulnerable populations. Such information may be helpful for designing service approaches in health care and child welfare that aim to mitigate emerging health concerns.…”

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confidence: 99%

“…2 Similar results are found in studies of children. For example, children experiencing more than one ACE were more than twice as likely to have dental caries, 12 38 percent more likely to exhibit poor emotional well-being, 11 and 21 percent more likely to have a chronic medical condition. 13 Furthermore, in our own research with children investigated for maltreatment, we found that for each additional ACE, children and youth were 29-44 percent more likely to have complex health concerns, depending on the developmental stage of the child.…”

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confidence: 99%

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Adverse childhood experiences and their relationship to complex health profiles among child welfare–involved children: A classification and regression tree analysis

Brown

Bender

Orsi

et al. 2019

Health Services Research

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Objective To identify the clustering of adverse childhood experiences (ACEs) that best characterize child welfare–involved children with known complex health concerns. Data Source Multi‐informant data were obtained from Wave I of the National Survey of Child and Adolescent Well‐Being (NSCAW II). Study Design This study used a cross‐sectional design and classification and regression tree (CART) analyses. Data Collection Data were collected from families with children, aged birth to 17, investigated for child maltreatment and their child protective services caseworkers, including demographic characteristics of the children, their histories of adversity, and a wide range of health concerns. Principal Findings Results indicate that for children between the ages of six and 17, experiences of physical abuse alone, as well as experiences of physical abuse combined with having a caregiver with mental illness, are most strongly associated with complex health concerns. For children aged 2‐5 years, results suggest that caregiver mental illness is a key adverse experience associated with complex health concerns. Conclusions Identifying specific combinations of ACEs may be a critical next step for child‐ and youth‐serving agencies to allow providers to better calculate risk of health problems among children exposed to adversity.

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Section: Introductionmentioning

confidence: 99%

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confidence: 99%

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confidence: 99%

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Adverse childhood experiences and their relationship to complex health profiles among child welfare–involved children: A classification and regression tree analysis

Brown

Bender

Orsi

et al. 2019

Health Services Research

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“…[17][18][19][20] Positive individual-, family-, and community-level factors, including high levels of family functioning and parental engagement, are associated with favorable outcomes for children and adolescents who have been exposed to ACEs. [21][22][23] Family functioning in particular is a protective factor against poverty, neighborhood violence, poor parental relationships, and adolescent mental health concerns. [24][25][26] One national study found that resilience, defined as "staying calm and in control when faced with a challenge," lessened the impacts of ACEs on grade repetition and poor school engagement.…”

Section: Prevalence and Impacts Of Aces In Adolescencementioning

confidence: 99%

Adverse Childhood Experiences and Resilience: Addressing the Unique Needs of Adolescents

Soleimanpour

Geierstanger

Brindis

2017

Academic Pediatrics

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Adolescents exposed to adverse childhood experiences (ACEs) have unique developmental needs that must be addressed by the health, education, and social welfare systems that serve them. Nationwide, over half of adolescents have reportedly been exposed to ACEs. This exposure can have detrimental effects, including increased risk for learning and behavioral issues and suicidal ideation. In response, clinical and community systems need to carefully plan and coordinate services to support adolescents who have been exposed to ACEs, with a particular focus on special populations. We discuss how adolescents' needs can be met, including considering confidentiality concerns and emerging independence; tailoring and testing screening tools for specific use with adolescents; identifying effective multipronged and cross-system trauma-informed interventions; and advocating for improved policies.KEYWORDS: adolescent health policy; adolescents; adverse childhood experiences; resilience; trauma ACADEMIC PEDIATRICS 2017;17:S108-S114 ADVERSE CHILDHOOD EXPERIENCES (ACEs) are increasingly a focus of both research and interventions nationwide, given emerging evidence of their high prevalence and lifelong health impacts. To date, much of the ACEs literature has focused on children and adults. Greater attention should be paid to the distinct developmental needs of adolescents and how the systems that serve them can more adequately respond.Distinct from both childhood and adulthood, adolescence is a unique developmental stage of rapid growth during which physiologic, cognitive, social, and emotional changes occur simultaneously. During this time (ages 11 to 21 years), adolescents experience physical and sexual maturation, develop more abstract and long-term thinking, and engage in risk-taking behaviors as they establish their independence. Adolescents who have experienced ACEs may be less able to successfully navigate this transformational stage as a result of the damaging effects of traumatic experiences on their emotional and cognitive development and/or lack of or limited positive supports.A large body of research has demonstrated that investments in early childhood can yield significant social and economic returns in adulthood and that this developmental stage should be prioritized for investments, particularly for disadvantaged youth. 1,2 However, this research also supports the notion that to maximize returns, there is a concurrent need to invest resources to address the needs of adolescents, particularly for those who may not have received needed supports in early childhood and/or who continue to experience ACEs into adolescence.Thus, adolescence represents a key window of opportunity to ameliorate the short-and longer-term impacts of trauma and positively alter the life course trajectory. High rates of trauma exposure have led to a pressing need to identify youth who have been exposed; recognize the varied ways in which youth respond to these experiences; identify effective strategies to provide traumainformed care; and d...

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“…Similar to the adult literature, research on the health and well-being of children also finds this association between adversity and poor health. Children exposed to adversity as compared to children without these exposures are at an increased risk for social disruptions, such as perpetrating violence and being involved in the criminal justice system; 52-56) mental health and behavioral problems, such as depression, anxiety and attention-deficit hyperactivity disorder; 57-66) obesity; [67][68][69][70] asthma; [71][72][73] risk for cardiovascular disease; 70,74) multiple somatic complaints such as headaches, fatigue, gastrointestinal 57,75,76) and perhaps, the most disturbing, is the negative impact on the developmental and intellectual functioning of children. 57,63,67,[77][78][79][80][81] The loss of the potential functional and intellectual capacity of people due to childhood violence exposure is daunting.…”

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confidence: 99%

Impact of Childhood Exposure to Intimate Partner Violence and Other Adversities

Franchek-Roa

Tiwari

Lewis‐O’Connor

et al. 2017

J Korean Acad Child Adolesc Psychiatry

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Childhood exposure to intimate partner violence (IPV) and other adversities has been shown to have adverse effects on health and well-being not only in childhood but also throughout the lifespan. This paper focuses on the prevalence of childhood adversities including exposure to IPV. The intersection of adverse childhood experiences and IPV victimization/perpetration in adulthood is also explored. The neurobiology of trauma is discussed and by understanding the impact of trauma on health, it is hoped that enhancement of resilience is possible. Based on the identification of protective factors at the individual, familial, and community level, examples of interventions that encourage safe, stable, and nurturing relationships between parents and children are described.Key Words: Childhood; Adversities; Intimate partner violence; Intersection; Trauma; Health; Resilience. lifespan. An important finding of the ACE study and subsequent studies 7,[12][13][14][15] is that children who have been exposed to one trauma are more likely to be exposed to multiple traumas and this phenomenon has been termed polyvictimization. 16) Polyvictimization is important to consider because poly-victims often have worse health and symptomatology than victims exposed to only one form of trauma. 17) Other researchers have conceptualized this exposure as cumulative trauma pointing out that not only is there trauma from exposure to violence throughout childhood and adolescence but especially for those in marginalized racial/ethnic, religious, and gender identity/sexual preference groups where there is also exposure to structural racism, micro-aggressions and historical trauma. 18) The more cumulative trauma, the more profound the effects on health. Table 1 shows the prevalence of ACEs and Table 2 shows the ACE score in selected studies from the US and from countries around the world. 7,[19][20][21][22][23][24][25][26][27][28][29] Although the studies had some differences in methodologies and ACE questions, there are some notable comparisons. The highest incidences of ACEs are found in the following countries: Sri Lankan men 28) had the highest incidences of childhood physical abuse (59.3%), childhood sexual abuse (27.2%), childhood physical neglect (37.9%); nearly tied with Albania 25) for witnessing domestic violence against the female caregiver (30% Albania, 29.3% Sri Lanka men); and had the highest prevalence of an ACE score of >4 ACEs (31.4%). The Philippines had the highest incidence of a caregiver abusing substances (drug abuse 7.5%; alcohol abuse 36.2%). 26) The US had the highest incidence of children exposed to caregivers with mental illness (19.4%). 7,19,20) Latvia (42.3%) 22) and Brazil (42%) 24) had the highest incidence of children exposed to parental separation. These comparisons illustrate the common theme of the ubiquity of trauma exposure for children worldwide.The ACE study and a plethora of subsequent studies, both in the US and worldwide, have linked adversity in childhood to organic diseases later in life. When c...

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Adverse childhood experiences, family functioning and adolescent health and emotional well-being

Cited by 142 publications

References 30 publications

Adverse childhood experiences and their relationship to complex health profiles among child welfare–involved children: A classification and regression tree analysis

Adverse childhood experiences and their relationship to complex health profiles among child welfare–involved children: A classification and regression tree analysis

Adverse Childhood Experiences and Resilience: Addressing the Unique Needs of Adolescents

Impact of Childhood Exposure to Intimate Partner Violence and Other Adversities

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