The Children

AbstractThe children’s early experiences provide a context for assessing subsequent outcomes. Data collected from case files and records presented to the courts show that before separation from birth parents, almost all 210 adoptees had experienced serious and often multiple forms of maltreatment; this was the primary reason for removal. Before entering their adoptive homes, 69% of the adoptees had had four or more adverse childhood experiences (ACEs), 32% had experienced failed reunifications and 48% had had three or more foster placements. Adverse childhood experiences before entry to care, harmful experiences in care and repeated exposure to grief and loss are likely to have contributed to the high prevalence of emotional and behavioural difficulties, displayed by 49% of the adoptees. According to our classification, 57% were at high risk of experiencing adverse outcomes in adulthood.

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Depressive psychopathology and adverse childhood experiences in eating disorders

European Psychiatry ◽

10.1016/j.eurpsy.2003.04.001 ◽

2003 ◽

Vol 18 (8) ◽

pp. 377-383 ◽

Cited By ~ 19

Author(s):

Mario Speranza ◽

Frederic Atger ◽

Maurice Corcos ◽

Gwenolé Loas ◽

Olivier Guilbaud ◽

...

Keyword(s):

Eating Disorders ◽

Life Events ◽

Adverse Childhood Experiences ◽

Clinical Sample ◽

Diagnostic Specificity ◽

Childhood Experiences ◽

Early Experiences ◽

Adverse Childhood ◽

The Impact

AbstractPurposeThe aim of this paper was to investigate the diagnostic specificity of the self-critical and dependent depressive experiences in a clinical sample of eating disorder patients and to explore the impact of adverse childhood experiences on these dimensions of personality.MethodA sample of 94 anorexic and 61 bulimic patients meeting DSM-IV criteria and 236 matched controls were assessed with the Depressive Experience Questionnaire (DEQ), the abridged version of the Beck Depression Inventory (BDI) and the AMDP Life Events Inventory. Subjects presenting a major depression or a comorbid addictive disorder were excluded from the sample using the Mini International Neuropsychiatric Interview (MINI).ResultsAnorexic and bulimic patients showed higher scores than controls on both self-criticism and dependency sub-scales of the DEQ. Bulimic patients scored significantly higher than anorexic patients on self-criticism and reported more adverse childhood experiences. Finally, negative life events correlated only with self-criticism in the whole sample.DiscussionDifferences in the DEQ Self-Criticism between anorexics and bulimics could not be accounted for by depression since bulimic patients did not show higher BDI levels compared to anorexic patients and depressive symptoms measured with the BDI were not found to be significant predictors of diagnostic grouping in a logistic multiple regression.ConclusionThis study supports the diagnostic specificity of the dependent and self-critical depressive dimensions in eating disorders and strengthens previous research on the role of early experiences in the development of these disorders.

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General practice recording of adverse childhood experiences: a retrospective cohort study of GP records

BJGP Open ◽

10.3399/bjgpopen20x101011 ◽

2020 ◽

Vol 4 (1) ◽

pp. bjgpopen20X101011 ◽

Cited By ~ 1

Author(s):

Andrea E Williamson ◽

Ross McQueenie ◽

David A Ellis ◽

Alex McConnachie ◽

Philip Wilson

Keyword(s):

Cohort Study ◽

Language Processing ◽

Retrospective Cohort Study ◽

Adverse Childhood Experiences ◽

Retrospective Cohort ◽

Adverse Outcomes ◽

Childhood Experiences ◽

Adverse Childhood ◽

General Practices ◽

Read Codes

BackgroundAdverse childhood experiences (ACEs) are linked to negative health outcomes in adulthood. Poor engagement with services may, in part, mediate the association between adverse outcomes and ACEs. While appointment recording is comprehensive, it is not yet known if or how ACEs are recorded in the GP clinical record (GPR).AimTo investigate recording of ACEs in the GPR and assess associations between available ACE-related Read codes and missed appointments.Design & settingRetrospective cohort study of 824 374 anonymised GPRs. Nationally representative sample of 136 Scottish general practices; data collected 2013–2016.MethodRead codes were mapped onto ACE questionnaire and wider ACE-related domains. Natural language processing (NLP) was used to augment capture of non-Read-coded ACEs. Frequency counts and proportions of mapped codes, and associations of these with defined levels of missing GP appointments, are reported.ResultsIn total, 0.4% of patients had a record of any code that mapped onto the ACE questionnaire, contrasting with survey-reported rates of 47% in population samples. This increased only modestly by including inferred ACEs that related to safeguarding children concerns, wider aspects of ACEs, and adult consequences of ACEs. Augmentation via NLP did not substantially increase capture. Despite poor recording, there was an association between ever having an ACE code recorded and higher rates of missing GP appointments.ConclusionGeneral practices would require substantial support to implement the recording of ACEs in the GPR. This study adds to the evidence that patients who often miss appointments are more likely to be socially vulnerable.

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