Associations between adverse childhood experiences, attitudes towards COVID-19 restrictions and vaccine hesitancy: a cross-sectional study

Abstract

ObjectivesAdverse childhood experiences (ACEs) can affect life-course health and well-being, including risk-taking behaviour and trust. This study explored associations between ACEs and trust in health information on COVID-19, attitudes towards and compliance with COVID-19 restrictions and vaccine hesitancy.DesignNational cross-sectional telephone survey using a sample of landline and mobile numbers stratified by Health Board, deprivation quintile and age group.SettingHouseholds in Wales during national COVID-19 restrictions (December 2020 to March 2021).Participants2285 Welsh residents aged ≥18 years.MeasuresNine ACEs; low trust in National Health Service (NHS) COVID-19 information; supporting removal of social distancing and mandatory face coverings; breaking COVID-19 restrictions; and vaccine hesitancy (rejection or uncertainty of vaccination).ResultsIncreasing ACE counts were independently related to low trust in NHS COVID-19 information, feeling unfairly restricted by government and ending mandatory face coverings. High ACE counts (4+ vs 0 ACEs) were also associated with supporting removal of social distancing. Breaking COVID-19 restrictions increased with ACE count with likelihood doubling from no ACEs to 4+ ACEs. Vaccine hesitancy was threefold higher with 4+ ACEs (vs 0 ACEs) and higher in younger age groups. Thus, modelled estimates of vaccine hesitancy ranged from 3.42% with no ACEs, aged ≥70 years, to 38.06% with 4+ ACEs, aged 18–29 years.ConclusionsACEs are common across populations of many countries. Understanding how they impact trust in health advice and uptake of medical interventions could play a critical role in the continuing response to COVID-19 and controlling future pandemics. Individuals with ACEs suffer greater health risks throughout life and may also be excluded from interventions that reduce infection risks. While pandemic responses should consider how best to reach those suffering from ACEs, longer term, better compliance with public health advice is another reason to invest in safe and secure childhoods for all children.

Coping with adverse childhood experiences during the COVID-19 pandemic: Perceptions of mental health service providers

“…Thus, it is imperative that clinical practices must be informed and trained to prevent, detect, and reduce the effect of multiple ACEs and improve health outcomes by incorporating resilience-building and trauma-informed services for individuals with multiple ACEs ( Hughes et al, 2017 ). Furthermore, most individuals with ACEs can improve their symptoms and health by being exposed to sources of resilience ( Bellis et al, 2022 ). Resilience is developed intrapersonally through maintaining positive cognitive and emotional processes, interpersonally through enhanced access to social support, and developing connectedness to the local communities ( Bellis et al, 2022 ).…”

“…Furthermore, most individuals with ACEs can improve their symptoms and health by being exposed to sources of resilience ( Bellis et al, 2022 ). Resilience is developed intrapersonally through maintaining positive cognitive and emotional processes, interpersonally through enhanced access to social support, and developing connectedness to the local communities ( Bellis et al, 2022 ). These were all themes echoed by MHPs in their interviews, with many of these factors being adversely impacted by the current pandemic’s social distancing guidelines disrupting traditional venues of healthy coping used by ACE patients.…”

“…Exposures to the upheaval of daily life from the pandemic can trigger individuals with a longitudinal history of ACEs to the point where they, in the act of self-perseveration and coping to a perceived stressor and existential threat, will seek immediate self-gratification and lose sight of the altruistic perspective of needing to engage in behaviors to protect others ( Meldrum et al, 2020 ; Bevilacqua et al, 2021 ). Instead, they accentuate their perceived victimization and trauma-instigated immense distrust of authority figures, including toward health professionals that they feel are exacerbating the upheaval experience of the pandemic ( Bellis et al, 2022 ). Therefore, even if services have been expanded due to use of telehealth, there is also a heightened intrinsic lack of motivation to seek care among some patients with ACEs, despite having active medical or psychiatric comorbid disorders that necessitate professional follow-up ( Sonu et al, 2021 ).…”

“…Therefore, even if services have been expanded due to use of telehealth, there is also a heightened intrinsic lack of motivation to seek care among some patients with ACEs, despite having active medical or psychiatric comorbid disorders that necessitate professional follow-up ( Sonu et al, 2021 ). Ultimately, it has been noted nationwide there is an increasing propensity for lapses of care in individuals with ACEs, who also face higher susceptibility to and morbidity to COVID-19 compared to the general population ( Földi et al, 2020 ; Huang et al, 2020 ; Bellis et al, 2022 ). Accordingly, the themes generated in this study may not be reflective of individuals with ACEs who never seek medical care with a MHP.…”

Pädiatrie aktuell – Forschung kurz notiert

“…Eine in The Lancet Public Health publizierte Studie untersuchte die Auswirkungen kindlicher Belastungen im weiteren Lebensverlauf [ 3 ]. Derartige Belastungen werden im englischen Sprachgebrauch als „adverse childhood experiences“ (ACE) bezeichnet.…”