Children’s mental health and diagnosis: Time for alternatives?

Adverse childhood experiences (ACEs) are associated with young people’s criminal legal system involvement, but the extent to which distinct types of ACEs and positive childhood experiences (PCEs) differentially relate to arrests and convictions for youth is unknown. We identified childhood exposures that remain independently associated with arrests and convictions by age 26 among a broad set of ACEs and PCEs. We conducted a cross-sectional analysis of data from two components of the nationally representative Panel Study of Income Dynamics. We examined the occurrence and number of arrests and convictions by age 26 and constructed ACE- and PCE-type indicator variables and overall scores. Weighted, covariate-adjusted logistic and negative binomial regression models estimated associations between ACE types and arrests and conviction outcomes, controlling for PCE score. Similarly, we estimated PCE-type outcome associations controlling for ACE score. Finally, we examined sex differences and stratified results by race. Of 7,200 participants, 14.9% were arrested by age 26. Controlling for PCE score, physical abuse and parental divorce/separation were associated with both arrests and convictions. Arrests were also associated with sexual abuse and parental substance use. Convictions were also associated with emotional abuse and parental mental health problems. Experiencing more PCEs was protective against arrest. We found sex differences for children experiencing sexual abuse. Certain ACEs appear more closely linked to young people’s risk of arrests and convictions, while combined PCE types may be protective. Interventions and policies that target these specific ACEs and boost PCEs may help disrupt pathways into the criminal legal system.

Protective and compensatory childhood experiences and their impact on adult mental health.

Military veterans have greater exposure to adverse childhood experiences (ACEs) than civilians and many also encounter warfare exposures, which can increase the likelihood of mental health problems. The purpose of this study was to test an interaction between childhood traumas and warfare exposures on the mental health of a sample of nearly 10,000 new post-9/11 veterans. Results revealed that male veterans exposed to one or two ACEs, but no warfare, were more likely to experience anxiety, depression, suicidal thinking, and angry outbursts than the reference group (i.e., no ACEs and no warfare exposure). Female veterans exposed to one or two ACEs, but no warfare, were only more likely to experience suicidal thinking. Male and female veterans exposed to three or more ACEs and no warfare were more likely to experience probable posttraumatic stress disorder (PTSD), anxiety, depression, suicidality, and angry outbursts. Among those veterans who experienced corollaries of combat only (e.g., seeing someone killed or seriously wounded), male, but not female veterans were more likely to have probable PTSD, anxiety, and depression. Veterans exposed to warfare (i.e., combat and the corollaries of combat), irrespective of ACEs exposure, were the most likely to report mental health symptoms. Implications for community-based mental health services are discussed.

Introduction: Adverse childhood experiences (ACEs) can contribute to significant health issues in adulthood. Aims: The present study seeks to understand the role of attachment and positive childhood experiences (PCEs) in the association between ACEs, self-rated emotional support and mental health. Methods: An online panel survey gathered data from 4,940 Slovenian adults aged 18 to 75. Simultaneous multiple regression path analysis (PROCESS) was used to test two moderation and mediation models. Results: Results indicate that ACEs were weakly associated with higher rates of anxious attachment and reduced self-rated mental health. Anxious attachment mediated the relation between ACEs and self-rated emotional support and self-rated mental health. PCEs were weakly negatively associated with anxious and avoidant attachment and interacted with ACEs in their effect on emotional support in adulthood. The strongest associations were found in the negative pathways between the two attachment styles (anxious and avoidant), emotional support, and self-rated mental health. Conclusions: These findings can guide (therapeutic) interventions for individuals with a history of child adversity: interventions could focus on addressing insecure attachment, involve a person’s social network as well as recognize and support the potential role of positive childhood experiences as protective factors.

BackgroundThe UK Department of Health has produced guidance on the statutory health assessment required for identifying and managing their health needs. It is well known that Children and young people...

It is recognised that parents of children diagnosed with ‘intellectual disability’ (ID) are marginalised through ableist social structures. This study was the first to explore if parents of children diagnosed with ID found developing a Power Threat Meaning Framework (PTMF) narrative useful for making sense of their experiences in non-pathologising ways. Data from repeated interviews with seven parents were synthesised using reflexive thematic analysis. Three superordinate themes were generated Altered worldview, capturing how the PTMF supported parents to develop new insights; Reflections on the PTMF as an approach, outlining parents’ critiques of the Framework; The applicability of the PTMF to parents and ID services, highlighting how the PTMF is implemented within services needs careful consideration. Overall, participants found the PTMF to be a helpful approach which they thought could support development of less pathologising and more empowering understandings of parenting experiences. Points of interest The Power Threat Meaning Framework (PTMF) was developed as an alternative to psychiatric diagnosis. Rather than diagnostic labels, it supports people to recognise that their distress is an understandable response to their social circumstances and what has happened to them. Seven participants developed PTMF narratives about their experiences parenting people with an ‘intellectual disability’. We were interested in whether parents found the process of developing the narratives useful. Parents said using the PTMF helped them to be less self-blaming. They found the process empowering. Parents thought it was important that their PTMF narrative was developed with someone familiar with the Framework over multiple sessions. They thought that using the Framework by themselves would have been difficult and less effective. Parents believed the PTMF could be helpful for other parents of people with ‘intellectual disabilities’. They thought it could help professionals to better understand why parents were responding to services the way they were. This might lead to better collaboration between services and parents. Parents were worried the PTMF could be misused. It is important parents have control over if, when, where and with whom they use the PTMF to explore their experiences.

Differences in adverse childhood experiences (ACEs) and quality of physical and mental health between transgender and cisgender sexual minorities

Although binge eating symptoms (BE) can contribute to worsened mental and physical health, little is known about factors associated with binge eating across the lifespan, hindering prevention and treatment. To investigate if there is an association between adverse childhood experiences (ACEs), adolescent and adult mental health conditions, and BE symptoms among young adults. One hundred and thirty-one junior high-school students participated in a series of assessments and 10 years later, 100 of these individuals participated in a follow-up assessment. Linear regression models were performed to estimate the association between ACEs, adolescent and emerging adult self-esteem, depression, and anxiety symptoms, and emerging adult BE symptoms. Among the sample, 26% had 1 ACEs, 18% had 2 ACEs, and 41% had ≥ 3ACEs. After adjusting for age, sex, and current mental health, there was a positive association between ACEs and increased levels of BE symptoms (β = 0.37, SE = 0.19, CI=(0.03; 0.7), p =.0485). Higher levels of emerging adult depression and anxiety symptoms (β = 0.02, SE = 0.01, CI=(0.01; 0.04), p =.0020) but not self-esteem (β = 0.04, SE = 0.05, CI=(-0.06; 0.14,) p =.4253), were associated with BE symptoms. Parental mental health, a parent experiencing a mental illness during the participant's childhood, was the only individual ACE associated with BE symptoms (β = 0.84, SE = 0.40, CI = 0.04, 1.64, p =.0409). Cumulative ACEs and emerging adult anxiety and depression symptoms were associated with BE symptoms. Findings indicate that ACEs, anxiety, and depression symptoms contribute to BE symptoms, highlighting the importance of screening for ACEs and mental health conditions. Persons struggling with BE symptoms may have co-occurring conditions, of which a traditional treatment for BE may not suffice.

Adverse childhood experiences (ACEs) are thought to have negative effects on mental health and well-being in adolescence. The definition of ACEs varies between studies, and their measurement is mainly based on questionnaires designed for adults to recall their childhood. This scoping review aimed to explore the research methods and findings from studies that quantitatively analysed the association between ACEs and mental health, behaviour, and educational performance in adolescence (ages 12-17). We sought to map and hypothesise the links or mechanisms between ACEs and these psychosocial outcomes by narrative synthesis of the methodologies and findings of the included studies, appraised with the Cambridge Quality Checklist. We searched MEDLINE, EMBASE, and PsychINFO from 1998 to July 2023 for relevant studies. We identified twenty studies that measured twenty-seven "ACEs" during childhood (ages 0-17), including abuse, neglect, household dysfunction, bullying, and other adversities. The definition of and measurement tools for ACEs and the analysis techniques were heterogeneous. ACEs were commonly analysed as the exposure of interest with factors around the child and family as confounders. Statistical techniques included regression modelling, mediation analysis, structural equation modelling, and decision tree classification. Eighteen studies estimated the cumulative effects of ACEs, either as ACEs count/score or latent classes; and four studies estimated individual ACE effects. Cumulative ACEs and most individual ACEs were positively associated with increased probabilities of negative adolescent psychosocial outcomes. Measuring ACEs during childhood and the associated impacts on adolescents appeared feasible in longitudinal studies and surveys. Heterogeneous ACE classification, psychometric properties of measurement tools, and the ACE score analysis approach limit the comparability and interpretation of findings. Future studies into the prevention or effects of ACEs on adolescent well-being and development should address factors leading to ACEs or mitigating their impacts on adolescent psychosocial development, and use triangulation in the research of ACEs.

Autistic youth experience high rates of adverse childhood experiences (ACEs), yet little is known about how different ACEs are associated with mental and physical health outcomes. The aims of this study were to identify latent classes of ACEs in autistic youth and examine how ACEs, measured via cumulative risk or latent class approaches, were associated with mental and physical health outcomes in autistic youth. We conducted a secondary analysis of the 2021-2022 National Survey of Children's Health, a U.S. cross-sectional dataset. The sample included 1,332 autistic youth aged 12-17. A latent class analysis (LCA) of 12 ACE indicators was conducted. Logistic regressions examined associations between ACEs and mental health (anxiety or depression diagnosis) and physical health (poor/fair vs. good/excellent health), controlling for youth characteristics. For each outcome, two regressions were conducted: one using cumulative ACE count (0-12) and one using latent class membership. A 3-class LCA model best fit the data: (1) Low ACEs, (2) Bullying and Discrimination, and (3) Household Disruption and Community Violence. For each outcome, cumulative ACE count and latent classes predicted similar variability. Compared to the Low ACEs class, youth in Class 2 and Class 3 were > 120% more likely to have a diagnosis of anxiety or depression; youth in Class 2 were > 75% more likely to have poor physical health. Findings highlight distinct patterns of ACEs among autistic youth and their links to health outcomes. Tailoring supports to specific types of adversities experienced by youth may foster resilience and promote well-being.

Objectives: This study aimed to (1) understand the associations between Adverse Childhood Experiences (ACEs) and poor adult health outcomes, specifically looking at both physical and mental health indicators, and (2) examine gender differences in ACEs’ impact on adult health outcomes.Methods: Data were obtained from the 2012 Korean General Social Survey. The study sample comprised 1,396 individuals aged ≥ 18 years who answered the ACE questionnaire. Controlling for sociodemographic factors, linear regression models were run to estimate the relationships between ACEs and adult physical (self-rated poor physical health status) and mental health indicators (depressive symptoms). Furthermore, the Chow test was carried out to ascertain whether there were any gender differences in ACEs’ impact on both adult physical and mental health outcomes.Results: Higher numbers of ACEs were significantly and positively associated with worse adult physical and mental health outcomes, such as poorer physical health status and higher levels of depressive symptoms compared with individuals who reported no adversities during childhood. In addition, gender differences were identified in ACEs’ impact on both health indicators, suggesting that females were at a higher risk of depression, while males were more likely to experience poor physical health.Conclusion: Adults reporting multiple adversities during childhood are more likely to experience poorer physical and mental health, demonstrating a strong, graded dose-response relationship between the number of ACEs and a range of negative adult health outcomes. Gender differences also exist in ACEs’ impact on adult physical and mental health, thus suggesting the need for gender-based intervention strategies to address ACEs in the adult population.

Adult correlates of adverse childhood experiences in Ukraine

Sexual and gender minority (SGM) individuals experience a greater burden of poor mental health compared to heterosexual individuals. One factor that helps to explain this disparity is trauma experienced during childhood. SGM are more likely to report traumatic experiences during childhood contributing to this disparity. Previous research has shown that resilience moderates the relationship between childhood trauma and adults mental health outcomes. As part of the Strengthening Colors of Pride project, data on 463 SGM adults living in San Antonio were collected using surveys. A diverse recruitment strategy was used in conjunction with a community advisory board. The brief resilience scale (BRS) was used to assess intrapersonal level resilience to determine if there was an effect on the relationship between ACEs and quality of mental and physical health. Differences were noted for some items across low, normal, and high levels of resilience. Both ACEs and BRS significantly predicted quality of mental and physical health. We also noted a significant interaction between ACEs and BRS with regard to quality of mental health. Findings suggest there is a relationship between intrapersonal level resilience, ACEs, and quality of mental health.

Service needs of young people affected by adverse childhood experiences (ACEs): A systematic review of UK qualitative evidence

Unpacking the impact of adverse childhood experiences on adult mental health