scholarly journals 1268. Clinic Screening for Adverse Childhood Experiences among Persons with HIV: A Pilot Project

2019 ◽  
Vol 6 (Supplement_2) ◽  
pp. S456-S456
Author(s):  
Priyanka Anand ◽  
Bryce Carter ◽  
Abby Bronstein ◽  
Alexis Schwartz ◽  
Brittney Harrington ◽  
...  
Keyword(s):  
Mental Health ◽  
General Population ◽  
Childhood Trauma ◽  
Adverse Childhood Experiences ◽  
Clinical Care ◽  
Pilot Project ◽  
Childhood Experiences ◽  
History Of Childhood ◽  
Adverse Childhood ◽  
History Of

Abstract Background Childhood trauma has long-lasting implications for adult health as prior work in the general population linked ≥4 adverse childhood experiences (ACEs) to multiple negative health outcomes in adulthood. History of childhood trauma is prevalent in people living with HIV (PLWH); however, screening for history of childhood trauma is not routinely performed in HIV clinical care. Methods We conducted a single-center, cross-sectional quality improvement pilot project to (1) define the prevalence of ACEs in PLWH engaged in care and (2) improve linkage with mental health resources. We hypothesized the prevalence of ≥4 ACEs in PLWH would be >21%, the prevalence previously reported in the local, general population. Patients were approached in the course of routine clinical care at an urban, academic HIV outpatient clinic between October 2018 and April 2019 and offered screening for ACEs, depression, and post-traumatic stress disorder (PTSD) using previously validated tools. Results Forty-nine patients completed the screening. Median age was 48 years [IQR: 37–55]; 69% were male and 53% were gay or bisexual. Most patients identified as black/African American (75%) and white (12%). Median ACEs score was 4 [IQR 1–6], with 51% (95% CI: 36–66%) reporting ≥4 ACEs (Figure 1), and most common ACE being guardian substance abuse (57%) (Figure 2). When compared with men, women had a higher median ACEs score (5 vs. 3, P = 0.04), history of childhood sexual abuse (67% vs. 26%, P <0.001), parent incarceration (53% vs. 24%, P = 0.04), and parental divorce or separation (73% vs. 41%, P = 0.04). Patients with ≥4 ACEs were more likely to have positive PTSD screens (56% vs. 21%, P = 0.02), moderate depression or greater (37% vs. 11%, P = 0.002), and were more likely to accept on-site mental health referral after screening (36% vs. 8%, P = 0.04). Acceptability of screening was deemed “very good” by patients, with median acceptability score 5 [IQR: 4–5] on a 5-point scale. Conclusion Over half of HIV+ patients screened in our clinic reported ≥4 ACEs, more than twice the prevalence of the general population. ACEs screening facilitated linkage of patients with high ACEs scores to mental healthcare. These results highlight the potential value of routine ACEs screening to enhance delivery of trauma-informed HIV primary care. Disclosures All authors: No reported disclosures.

Adverse Childhood Experiences, Brain Development, and Mental Health: A Call for Neurocounseling

2018 ◽  
Vol 40 (3) ◽  
pp. 266-278 ◽  
Author(s):  
Carryl P. Navalta ◽  
Lesley McGee ◽  
Jolene Underwood
Keyword(s):  
Mental Health ◽  
Adverse Childhood Experiences ◽  
Brain Structures ◽  
Cumulative Exposure ◽  
Childhood Experiences ◽  
Psychotherapeutic Interventions ◽  
Ace Study ◽  
Adverse Childhood ◽  
Health Related ◽  
History Of

The Adverse Childhood Experiences (ACE) Study provided compelling evidence that abuse, neglect, and other ACEs are the most potent risk factors for the development of health, mental health, and substance use problems. Such negative health-related outcomes parallel the cumulative exposure of the developing brain to the stress response, with resulting impairment in multiple brain structures and functions. Collectively, these sequelae can manifest during childhood, adolescence, or adulthood. We and others have posited that counseling and other psychotherapeutic interventions need to address the individual's multilayered ecology (i.e., biological, psychological, social, cultural/contextual). Neurocounseling can provide a heuristic framework to more effectively assess, conceptualize, and counsel people with a history of ACEs. We provide an update of the clinical neuroscience of ACEs and its implications for counseling, including how contemporary interventions (e.g., mindfulness) can potentially have positive benefits for such individuals.

scholarly journals The Association between a History of Parental Addictions and Arthritis in Adulthood: Findings from a Representative Community Survey

2014 ◽  
Vol 2014 ◽  
pp. 1-10 ◽  
Author(s):  
Esme Fuller-Thomson ◽  
Jessica P. Liddycoat ◽  
Maria Stefanyk
Keyword(s):  
Mental Health ◽  
Risk Factors ◽  
Socioeconomic Status ◽  
Health Behaviors ◽  
Adverse Childhood Experiences ◽  
Adult Health ◽  
Childhood Experiences ◽  
Adverse Childhood ◽  
History Of ◽  
The Relationship

Aims. To examine the relationship between a history of parental addictions and the cumulative lifetime incidence of arthritis while controlling for age, sex, race, and four clusters of risk factors: (1) other adverse childhood experiences, (2) adult health behaviors (i.e., smoking, obesity, inactivity, and alcohol consumption), (3) adult socioeconomic status and (4) mental health. Materials and Methods. Secondary analysis of 13,036 Manitoba and Saskatchewan respondents of the population-based 2005 Canadian Community Health Survey. Sequential logistic regression analyses were conducted. Findings. After controlling for demographic characteristics, including age, gender, and race, respondents who reported a history of parental addictions had significantly higher odds of arthritis in comparison to individuals without (OR=1.58; 95% CI 1.38–1.80). Adjustment for socioeconomic status, adult health behaviors, and mental health conditions had little impact on the parental addictions and arthritis relationship. The association between parental addictions and arthritis was substantially reduced when adverse childhood experiences (OR=1.33; 95% CI 1.15–1.53) and all four groups of risk factors collectively (OR=1.30; 95% CI = 1.12–1.51) were included in the analyses; however, the relationship remained statistically significant. Conclusions. A robust association was found between parental addictions and cumulative lifetime incidence of arthritis. This link remained even when controlling for four groups of potential risk factors.

Current Posttraumatic Stress Symptoms Mediate the Relationship Between Adverse Childhood Experiences and Executive Functions

2021 ◽  
pp. 003329412097969
Author(s):  
Rachel A. Maja ◽  
Robyn E. Kilshaw ◽  
Mauricio A. Garcia-Barrera ◽  
Justin E. Karr
Keyword(s):  
Executive Function ◽  
Executive Functions ◽  
Posttraumatic Stress ◽  
Symptom Severity ◽  
Adverse Childhood Experiences ◽  
Childhood Experiences ◽  
History Of Childhood ◽  
Adverse Childhood ◽  
History Of ◽  
The Relationship

Adverse childhood experiences (ACEs) and posttraumatic stress disorder (PTSD) are both associated with lower performances on executive function tasks. However, few researchers have evaluated ACEs, posttraumatic stress (PTS) symptoms, and executive function difficulties in conjunction. Using an online micropayment service, the current study assessed whether PTS symptoms mediated the relationship between ACEs and executive functions. In total, 83 participants (54.2% female, age: M = 28.86, SD = 7.71) were administered the ACE questionnaire, PTSD Checklist for DSM-5 (PCL-5), and the Executive Function Index (EFI). A higher number of reported ACEs was related to greater PTS symptom severity ( β = .40, p < .001) and worse self-rated executive functions ( β = –.32, p = .002). Controlling for the number of reported ACEs, current PTS symptom severity was related to worse executive functions ( β = –.45, p < .001). A bootstrapped 95% confidence interval (CI) indicated a significant indirect effect, β = –.18 (95% CI: –.30, –.08), by which current PTS symptoms mediated the relationship between the number of reported ACEs and executive functions. These results suggest that psychological interventions targeting PTS symptoms, in the context of a history of childhood trauma, may concurrently improve executive functions in adult populations.

Correlation of pre-exposure prophylaxis adherence to a mental health diagnosis or experience of childhood trauma in high-risk youth

2020 ◽  
Vol 31 (5) ◽  
pp. 440-446
Author(s):  
Lindsay B Young ◽  
Linden Lalley-Chareczko ◽  
Devon Clark ◽  
Michael T Ramos ◽  
Rachel A Nahan ◽  
...  
Keyword(s):  
Mental Health ◽  
Major Depression ◽  
Childhood Trauma ◽  
P Value ◽  
Generalized Anxiety ◽  
Childhood Experiences ◽  
History Of Childhood ◽  
History Of ◽  
Student’S T ◽  
Exposure Prophylaxis

Pre-exposure prophylaxis (PrEP) with tenofovir disoproxil fumarate (TDF)/emtricitabine is 99% effective in preventing HIV when taken daily. Young men/transgender women of color who have sex with men are the most at risk to become infected with HIV, with the lowest PrEP adherence. We investigated the association of depression, anxiety, and history of childhood trauma with PrEP adherence. PrEP adherence was measured by urine TDF testing. Patients were evaluated for depression (Patient Health Questionnaire-9 [PHQ-9]), anxiety (Generalized Anxiety Disorder-7 [GAD-7]), and history of childhood trauma (Adverse Childhood Experiences [ACEs]). Urine TDF levels were compared across scores on each screening tool using a Student’s t-test. A p-value of ≤ 0.05 was considered significant. Thirty-one subjects (mean age: 21.7 years, SD: 2.8) were enrolled between 3/2015 and 7/2016. Lower PrEP adherence was associated with a GAD-7 score diagnostic for generalized anxiety (80.7% versus 92.7%, p = 0.04) and a high ACE score (4+) (84.5% versus 95.7%, p = 0.05). A PHQ-9 score diagnostic for major depression was not associated with PrEP adherence. The presence of generalized anxiety and a history of childhood trauma, but not major depression, were associated with decreased PrEP adherence. The benefits of mental health interventions and trauma-informed care in PrEP programs should be considered in larger studies to potentially increase adherence.

Maternal History of Childhood Adversities and Later Negative Parenting: A Systematic Review

2021 ◽  
pp. 152483802110360
Author(s):  
Camila Regina Lotto ◽  
Elisa Rachel Pisani Altafim ◽  
Maria Beatriz Martins Linhares
Keyword(s):  
Adverse Childhood Experiences ◽  
Parenting Practices ◽  
Negative Impact ◽  
Childhood Adversities ◽  
Maternal History ◽  
Childhood Experiences ◽  
Negative Parenting ◽  
History Of Childhood ◽  
Adverse Childhood ◽  
History Of

Adverse childhood experiences negatively impact future violence, victimization, perpetration, health, and lifelong development. The aim of the present study was to systematically review the scientific evidence of empirical studies on the association between maternal childhood adversity in a familial context, including maltreatment, household challenges, and later maternal negative parenting. A search was performed in the PubMed, PsycINFO, Web of Science, SciELO, and LILACS databases, using the combination of the following keywords: (neglect OR abuse OR maltreatment OR harsh parenting OR punishment OR discipline OR negative parenting practices) AND (adverse childhood experiences OR early adversity OR cycle of violence OR cycle of maltreatment OR history of maltreatment) AND (mother OR maternal). The results of 29 studies showed predominantly significant direct associations between maternal childhood adversities and negative parenting with their children (83%). Parental stress was also significantly associated with a maternal history of childhood adversities. Focusing on the type of maltreatment practices, there were similar intergenerational transmission types: homotypic and heterotypic. Few studies have examined the protective factors that could buffer the negative impact of a maternal childhood history of adversities on later negative parenting.

scholarly journals Exploring the health and service utilisation of general practice patients with a history of adverse childhood experiences (ACEs): an observational study using electronic health records

BMJ Open ◽  
2020 ◽  
Vol 10 (9) ◽  
pp. e036239
Author(s):  
Katie Hardcastle ◽  
Mark A Bellis ◽  
Catherine A Sharp ◽  
Karen Hughes
Keyword(s):  
Mental Health ◽  
Health Service ◽  
Adverse Childhood Experiences ◽  
Mental Health Problems ◽  
Health Problems ◽  
Service Utilisation ◽  
Health Records ◽  
Childhood Experiences ◽  
Adverse Childhood ◽  
History Of

ObjectivesTo examine the relationships between adverse childhood experiences (ACEs), chronic health and health service utilisation among a sample of general practice patients.DesignCross-sectional observational study using anonymised data from electronic health records for 763 patients.SettingFour general practices in northwest England and North Wales.Outcome measuresPatient demographic data (age, gender); body mass index; self-reported smoking status; self-reported ACEs; diagnosis of chronic health conditions; current mental health problems; total number of service contacts and repeat medication use in the previous 6 months.ResultsA history of ACEs (experiencing abuse or neglect as a child, and/or growing up in a household characterised by violence, substance use, mental health problems or criminal behaviour) was strongly independently associated with current mental health problems, smoking and chronic obstructive pulmonary disease, showing a dose–response relationship with level of ACE exposure. Medication use and contact were significantly greater among patients with high ACE exposure (≥4 ACEs), compared with those with no ACEs. However, contrary to findings from population studies, health service utilisation was not significantly different for patients with increased ACE exposure (1–3 ACEs) and their ACE-free counterparts.ConclusionsFindings highlight the contribution ACEs make to unequal distributions of risk to health and well-being and patterns of health service use in the UK.

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