Confirmatory Factor Analysis of Adverse Childhood Experiences (ACEs) among a Community-Based Sample of Parents and Adolescents

Afifi, Tracie O.; Salmon, Samantha; Davila, Isabel Garces; Struck, Shannon; Fortier, Janique; Taillieu, Tamara; Stewart-Tufescu, Ashley; Asmundson, Gordon J.G.; Sareen, Jitender; MacMillan, Harriet L.

doi:10.21203/rs.2.17821/v1

Cited by 7 publications

(10 citation statements)

References 20 publications

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“…They describe it as a 'chaotic concept' -an abstraction that conflates different issues, divides processes that should be considered indivisible, leading to problems in the development of related policies and interventions, with significant limitations in the body of evidence and the measures used. This is congruent with other research suggesting that little has been done to improve the definition and conceptualisation of ACEs since the model was first developed (Afifi et al, 2020). White and colleagues (2019) recognise that the creation of the model and the resulting policy implementations are well-intended.…”

Section: Summary Of the Aces Model And Its Criticismssupporting

confidence: 81%

The arrival of the ACEs movement in Scotland: Policy entrepreneurship and critical activist responses

Walsh¹

2020

Scottish Affairs

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This paper combines conceptual and documentary analysis to critique the recent introduction of ACEs (Adverse Childhood Experiences) in Scottish social policy, highlighting the role of the ACE-Aware Nation ‘movement’ and its positioning of the ACEs model through its campaigning activities. Consideration is given to the role of a sophisticated network of policy entrepreneurs and the commercial and political interests at play. Reflection is offered on the critical activist responses to this campaign that seek to highlight the socio-economic and political underpinnings of childhood trauma, which are largely absent in the ACEs model. The argument is that these policy developments amount to a recent turn to the ACEs model as a simplistic solution to complex social problems – a solution that is shown to be ultimately flawed in several respects. This analysis reveals the contradictions, conflicts and confusion that have emerged within the ACEs discourse, caused in the main by heuristic thinking and the conceptual inadequacies, misuses and misunderstandings of the ACEs model. The paper concludes that policy makers and practitioners should exercise caution in their appraisal of the ACEs model and the associated movement in Scotland.

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Section: Summary Of the Aces Model And Its Criticismssupporting

confidence: 81%

The arrival of the ACEs movement in Scotland: Policy entrepreneurship and critical activist responses

Walsh¹

2020

Scottish Affairs

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“…Table 4 shows the distribution of mental health outcomes for ACEs reported prospectively and retrospectively, categorized as 'less than four' or 'four or more'. Given patterns in the literature associating adversity in childhood with poor mental health [12,13], it is expected that a greater proportion of respondents who report four or more ACEs will present with psychological distress. Using prospective reports of ACEs there appears to be little significance between reported ACEs and psychological distress (somatization, p = 0¢465; anxiety, p = 0¢263; social dysfunction, p = 0¢522; depression, p = 0¢050; GHQ total, p = 0¢273).…”

Section: Associations Between Aces and Mental Health Outcomesmentioning

confidence: 99%

“…For example, one study linked a cluster of ACEs related to abuse and neglect to higher severity bipolar disorder and schizophrenia, compared to a cluster of social supportrelated ACEs [12]. In another study on the clustering of individual ACEs, a child maltreatment and peer victimization group was associated with double the odds of self-rated poor physical health and three times the odds of self-rated poor mental health, compared to a household challenges grouping which was linked to an almost 3-fold chance of reporting poor physical health and six-times odds of reporting poor mental health [13].…”

Section: Introductionmentioning

confidence: 97%

Secondary analysis of retrospective and prospective reports of adverse childhood experiences and mental health in young adulthood: Filtered through recent stressors

2021

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Background: Evidence has identified the detrimental effects that adverse childhood experiences (ACEs) have on outcomes across the life course. We assess associations between prospective and retrospective ACEs and mental health in young adulthood and the influence of recent stressors. Methods: Secondary analysis of a sample of 1592 young adults from the Birth to Twenty Plus cohort, from 1990 to 2013, were assessed throughout their first 18 years for prospective ACEs. Retrospective ACEs and an assessment of mental health were collected at the 22À23-year data point. Findings: Prospective physical and sexual abuse are associated with an increased risk of depression (OR 1¢7 [95% CI 1¢37À1¢93, p = 0¢034], and OR 1¢8 [95% CI 1¢27À2¢07, p = 0¢018], respectively). Retrospective emotional abuse/neglect is associated with increased anxiety (OR 1¢8 [95% CI 1¢32À2¢36, p = 0¢000]), depression (OR 1¢6 [95% CI 1¢08À2¢25, p = 0¢018]) and overall psychological distress (OR 1¢6 [95% CI 1¢18À2¢17, p = 0¢002]). Prospectively reporting four or more ACEs is associated with a twofold increase in risk for overall psychological distress (OR 2¢2 [95% CI 1¢58À3.12, p = 0¢008]). Retrospectively reporting four or more ACEs is associated with increased likelihood of somatization (p = 0¢004), anxiety (p = 0¢002), depression (p = 0¢021), and overall psychological distress (p = 0¢005). Interpretation: Both individual and combined retrospective and prospective ACEs are related to mental health in young adulthood. Recent stressors reinforce this relationship; the likelihood of those who report more ACEs experiencing psychological distress increases when adjusting for recent stressors.

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“…Adverse childhood experiences : The Center for Youth Wellness Adverse Childhood Experiences Questionnaire (CYW ACE‐Q) was developed in partnership by the Center for Youth Wellness and Bayview Child Health Center. The CYW ACE‐Q is comprised of two sections: Section 1 includes the original 10 ACEs (individual ± familial level) 8 ; Section 2 includes seven (CYW ACE‐Q Child) and nine (CYW ACE‐Q Adolescent and CYW ACE‐Q Adolescent Self‐Report) additional community‐level stressors hypothesized by experts and community stakeholders to be more representative of the adversities experienced across socioeconomic groups 14–18 . These additional stress categories include racism/discrimination, bullying, involvement in the foster care system, family separation due to deportation, loss of a parent/caregiver due to death, exposure to neighborhood/school violence, and life‐threatening medical experiences/conditions.…”

Section: Methodsmentioning

confidence: 99%

Adverse childhood experiences in children and adolescents with sickle cell disease: A retrospective cohort study

Pernell

Nagalapuram

Lebensburger

et al. 2021

Pediatric Blood & Cancer

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Background Adverse childhood experiences (ACEs) are linked to poor health outcomes; however, the relationship between ACEs and health outcomes among children and adolescents with sickle cell disease (SCD) has limited documentation in the published literature. Procedure This retrospective cohort study involved 45 children and 30 adolescents. Participants were screened using the Center for Youth Wellness ACE Questionnaire. Parents completed the questionnaire for children. Adolescents provided self‐report. ACEs were treated as continuous and categorical scales: 0–1 verus ≥2 original ACEs (individual and/or familial level); 0–1 versus ≥2 additional ACEs (community level); and 0–3 versus ≥4 expanded ACEs (original + additional). Pain and acute chest syndrome events were compared using Wilcoxon rank‐sum tests, and correlated with cumulative ACE scores using Spearman's correlation. Multivariable models were fitted to examine the association between ACEs and pain/acute chest syndrome. Results The cumulative number of original ACEs positively correlated with acute chest syndrome events (rho = .53, p = .003) and pain (rho = .40, p = .028) among adolescents. Adolescents with ≥2 versus 0–1 original ACEs had a higher number of acute chest syndrome events (4.9 ± 2.6 vs. 1.6 ± 2.2, p = .002); however, this association was confounded by asthma. Acute chest syndrome events and hospitalizations for pain did not differ among child ACE groups. Emergency department (ED) pain visits were higher among children with ≥4 versus 0–3 expanded ACEs (1.6 ± 2.8 vs. 3.3 ± 3.2, p = .042), even after controlling for SCD genotype, asthma, disease‐modifying treatment, and follow‐up years (p = .027). Conclusion ACEs are linked to increased morbidity among children and adolescents with SCD. Prospective studies are needed to further understand this relationship and test ACE‐protective remedies.

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Confirmatory Factor Analysis of Adverse Childhood Experiences (ACEs) among a Community-Based Sample of Parents and Adolescents

Abstract: Background Despite increased understanding of Adverse Childhood Experiences (ACEs), very little advancement has been made in how ACEs are defined and conceptualized. The current objectives were to determine: 1) the factor structure of the original ACEs and possible expanded ACEs, and 2)

Cited by 7 publications

References 20 publications

The arrival of the ACEs movement in Scotland: Policy entrepreneurship and critical activist responses

The arrival of the ACEs movement in Scotland: Policy entrepreneurship and critical activist responses

Secondary analysis of retrospective and prospective reports of adverse childhood experiences and mental health in young adulthood: Filtered through recent stressors

Adverse childhood experiences in children and adolescents with sickle cell disease: A retrospective cohort study

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