Examining Associations between Adverse Childhood Experiences and Posttraumatic Stress Disorder Symptoms among Young Survivors of Urban Violence

Abstract

Our study examines the association between Adverse Childhood Experience (ACE) exposure and posttraumatic stress disorder (PTSD) symptoms among survivors of violence. In this cross-sectional study, an ACE questionnaire and PTSD Checklist for DSM-5 (PCL-5) were completed by 147 participants ≤ 3 months after presenting to a Philadelphia, PA emergency department between 2014 and 2019 with a violent injury. This study treated ACEs, both separate and cumulative, as exposures and PTSD symptom severity as the outcome. Most participants (63.3%) met criteria for provisional PTSD, 90% reported experiencing ≥ 1 ACE, and 39% reported experiencing ≥ 6 ACEs. Specific ACEs were associated with increasing PCL-5 scores and increased risk for provisional PTSD. Additionally, as participants’ cumulative ACE scores increased, their PCL-5 scores worsened (b = 0.16; p < 0.05), and incremental ACE score increases predicted increased odds for a positive provisional PTSD screen. Results provide further evidence that ACEs exacerbate the development of PTSD in young survivors of violence. Future research should explore targeted interventions to treat PTSD among survivors of interpersonal violence.

Mental health symptoms and engagement in a stepped-care mental health service among patients with a violent versus nonviolent injury

“…These interaction effects are likely to be more pronounced among patients with a violently injury. Research has found that 50% to 57% 2,22 of patients with a violent injury report four or more adverse childhood experiences, which is associated with an increased risk of mental and physical health problems, 23 compared with only 11% of patients who experienced a motor vehicle collision or severe burn 24 . These complex circumstances may overwhelm some individuals' ability to cope effectively after they are violently injured and make it challenging for them to seek out and engage in mental health resources like TRRP without support (e.g., referrals, appointment reminders, transportation).…”

Adverse childhood events and mental health problems in cancer survivors: a systematic review

“…People who experience more adverse events during childhood are more likely to develop chronic illnesses such as heart disease, respiratory disease, and cancer [4]. Also, they are susceptible for developing depression, anxiety, and posttraumatic stress disorders [5][6][7]. The reasons why adverse childhood events may lead to poor health are diverse and still not completely understood, but sustained activation of the stress response system is assumed to be at the heart of this relationship.…”

Childhood mental health difficulties mediate the long‐term association between early‐life adversity at age 3 and poorer cognitive functioning at ages 11 and 14

“…Similarly, early‐life adversity has been associated with a greater mental health burden in adolescence and early adulthood (Gilbert et al., 2009) as well as earlier onset of mental illness (McLaughlin et al., 2012). Numerous cross‐sectional studies report that maltreated or stress‐exposed children have higher depressive and anxiety symptoms (Dunn, Nishimi, Powers, & Bradley, 2017; Kim, Jang, Chang, Park, & Lee, 2013), behavioral problems (Yates, Dodds, Sroufe, & Egeland, 2003), posttraumatic experiences (Tabb et al., 2022), and suicidal ideation (Afifi et al., 2008). These findings have been replicated in a longitudinal study which found that early‐life adversity is associated with higher depressive symptoms, suicidality, and comorbid anxiety (Klein et al., 2009).…”