scholarly journals The relationship between adverse childhood experiences and educational disadvantage: A critical perspective

2020 ◽  
Vol 29 (4) ◽  
pp. 493-501
Author(s):  
Karen Goodall ◽  
Hannah Robertson ◽  
Matthias Schwannauer
Keyword(s):  
Adverse Childhood Experiences ◽  
Risk Model ◽  
Cumulative Risk ◽  
Physical And Mental Health ◽  
Educational Impact ◽  
Childhood Experiences ◽  
Educational Disadvantage ◽  
Adverse Childhood ◽  
Cumulative Risk Model ◽  
Negative Impacts

In the last 25 years, converging evidence has supported the view that adverse childhood experiences (ACEs) have long term negative impacts on physical and mental health. More recently, ACEs have been negatively associated with a range of educational measures. As educational attainment is a determining factor in later socioeconomic position, the education system is likely to play a significant role in responding to ACEs. A critical and reflective examination of the available research will be crucial to intervening in evidence-based ways. While the ACEs movement has been instrumental in highlighting the educational impact of inequality in childhood, the ACEs research is often difficult to parse due to a reliance on checklists and a cumulative risk model. At present, the mechanisms that link ACEs to educational outcomes are still under-researched. Continued discussion of the concept of ACEs and the strengths and limitations of the current research is warranted.

scholarly journals Contrasting cumulative risk and multiple individual risk models of the relationship between Adverse Childhood Experiences (ACEs) and adult health outcomes

2020 ◽  
Vol 20 (1) ◽  
Author(s):  
Marianna D. LaNoue ◽  
Brandon J. George ◽  
Deborah L. Helitzer ◽  
Scott W. Keith
Keyword(s):  
Adverse Childhood Experiences ◽  
Conceptual Models ◽  
Risk Model ◽  
Cumulative Risk ◽  
Model Fit ◽  
Individual Risk ◽  
Adult Health ◽  
Childhood Experiences ◽  
Adverse Childhood ◽  
Best Fit

Abstract Background A very large body of research documents relationships between self-reported Adverse Childhood Experiences (srACEs) and adult health outcomes. Despite multiple assessment tools that use the same or similar questions, there is a great deal of inconsistency in the operationalization of self-reported childhood adversity for use as a predictor variable. Alternative conceptual models are rarely used and very limited evidence directly contrasts conceptual models to each other. Also, while a cumulative numeric ‘ACE Score’ is normative, there are differences in the way it is calculated and used in statistical models. We investigated differences in model fit and performance between the cumulative ACE Score and a ‘multiple individual risk’ (MIR) model that enters individual ACE events together into prediction models. We also investigated differences that arise from the use of different strategies for coding and calculating the ACE Score. Methods We merged the 2011–2012 BRFSS data (N = 56,640) and analyzed 3 outcomes. We compared descriptive model fit metrics and used Vuong’s test for model selection to arrive at best fit models using the cumulative ACE Score (as both a continuous or categorical variable) and the MIR model, and then statistically compared the best fit models to each other. Results The multiple individual risk model was a better fit than the categorical ACE Score for the ‘lifetime history of depression’ outcome. For the outcomes of obesity and cardiac disease, the cumulative risk and multiple individual risks models were of comparable fit, but yield different and complementary inferences. Conclusions Additional information-rich inferences about ACE-health relationships can be obtained from including a multiple individual risk modeling strategy. Results suggest that investigators working with large srACEs data sources could empirically derive the number of items, as well as the exposure coding strategy, that are a best fit for the outcome under study. A multiple individual risk model could also be considered in addition to the cumulative risk model, potentially in place of estimation of unadjusted ACE-outcome relationships.

scholarly journals Contrasting Cumulative Risk and Multiple Individual Risk Models of the Relationship Between Adverse Childhood Experiences (ACEs) and Adult Health Outcomes

2020 ◽  
Author(s):  
Marianna LaNoue ◽  
Brandon J George ◽  
Deborah L Helitzer ◽  
Scott W Keith
Keyword(s):  
Adverse Childhood Experiences ◽  
Conceptual Models ◽  
Risk Model ◽  
Cumulative Risk ◽  
Model Fit ◽  
Individual Risk ◽  
Adult Health ◽  
Childhood Experiences ◽  
Adverse Childhood ◽  
Best Fit

Abstract Background: A very large body of research documents relationships between self-reported Adverse Childhood Experiences (srACEs) and adult health outcomes. Despite multiple assessment tools that use the same or similar questions, there is a great deal of inconsistency in the operationalization of self-reported childhood adversity for use as a predictor variable. Alternative conceptual models are rarely used and very limited evidence directly contrasts conceptual models to each other. Also, while a cumulative numeric ‘ACE Score’ is normative, there are differences in the way it is calculated and used in statistical models. We investigated differences in model fit and performance between the cumulative ACE Score and a ‘multiple individual risk’ (MIR) model that enters individual ACE events together into prediction models. We also investigated differences that arise from the use of different strategies for coding and calculating the ACE Score.Methods: We merged the 2011-2012 BRFSS data (N = 56,640) and analyzed 3 outcomes. We compared descriptive model fit metrics and used Vuong’s test for model selection to arrive at best fit models using the cumulative ACE Score (as both a continuous or categorical variable) and the MIR model, and then statistically compared the best fit models to each other.Results: The multiple individual risk model was a better fit than the categorical ACE Score for the ‘lifetime history of depression’ outcome. For the outcomes of obesity and cardiac disease, the cumulative risk and multiple individual risks models were of comparable fit, but yield different and complementary inferences.Conclusions: Additional information-rich inferences about ACE-health relationships can be obtained from including a multiple individual risk modeling strategy. Results suggest that investigators working with large srACEs data sources could empirically derive the number of items, as well as the exposure coding strategy, that are a best fit for the outcome under study. A multiple individual risk model could also be considered in addition to the cumulative risk model, potentially in place of estimation of unadjusted ACE-outcome relationships.

scholarly journals Contrasting Cumulative Risk and Multiple Individual Risk Models of the Relationship Between Adverse Childhood Experiences (ACEs) and Adult Health Outcomes

2020 ◽  
Author(s):  
Marianna LaNoue ◽  
Brandon J George ◽  
Deborah L Helitzer ◽  
Scott W Keith
Keyword(s):  
Health Outcomes ◽  
Adverse Childhood Experiences ◽  
Risk Model ◽  
Cumulative Risk ◽  
Model Fit ◽  
Self Report ◽  
Individual Risk ◽  
Adult Health ◽  
Childhood Experiences ◽  
Adverse Childhood

Abstract Background A majority of the documented relationships between adverse childhood experiences (ACEs) and adult health outcomes are based in cross-sectional self-reported datasources such as the CDC’s Behavioral Risk Factor Surveillance System survey. Despite using the same or similar questions, there is a great deal of inconsistency in the operationalization of self-reported childhood adversity for use as a predictor variable. A cumulative risk model, resulting in a cumulative numeric ‘ACE Score’, is normative but there are differences in the way the ACE Score is calculated and used in statistical models. Alternative conceptual models are rarely used, even though predictor characterization directly impacts interpretations about the effects of adversity on outcomes. We investigated differences in model fit and performance between the cumulative ACE Score and a ‘multiple individual risk’ model that enters individual ACE events individually into prediction models. Methods We merged the 2011–2012 BRFSS data (N = 56,640) and analyzed 3 self-report outcomes. We compared model fit metrics and used Vuong’s test for model selection to arrive at a best fit model. Results The multiple individual risk model was a better fit than the categorical ACE Score for the ‘lifetime history of depression’ outcome. For the outcomes of obesity and cardiac disease, the cumulative risk and multiple individual risks models were of comparable fit, but yield very different inferences. Conclusions Additional information-rich inferences about ACE-health relationships can be obtained from including a multiple individual risk modeling strategy, either in addition to or in place of a cumulative risk ACE Score.

Abstract 30: Role For Adverse Childhood Experiences And Depression In Preeclampsia

Hypertension ◽  
2021 ◽  
Vol 78 (Suppl_1) ◽  
Author(s):  
Monica C Myers ◽  
Mark K Santillan ◽  
Debra S Brandt ◽  
Amy K Stroud ◽  
Julie A Vignato ◽  
...  
Keyword(s):  
Postpartum Depression ◽  
Adverse Childhood Experiences ◽  
Depression Scale ◽  
Severe Depression ◽  
Late Pregnancy ◽  
Physical And Mental Health ◽  
Childhood Experiences ◽  
Adverse Experiences ◽  
Adverse Childhood ◽  
Patient Health

Hypertensive diseases are associated with adverse experiences in childhood as well as depression. In order to determine if these associations were present in women with preeclampsia (PreE), a particularly devastating hypertensive disease in pregnancy, the scores from three questionnaires: Adverse Childhood Experiences (ACE), Edinburgh Postnatal Depression Scale (EPDS), and the Patient Health Questionnaire-9 (PHQ-9) were compared between women with PreE (n=32) and women without PreE (n=46) between 9 and 48 months postpartum (IRB# 201808705). ACE scores are calculated by summing an individual’s affirmative responses to specific adverse experiences during childhood. In our study, the average ACE score of individuals with PreE was higher than that of women without PreE (1.69 vs. 1.02, P=.04). We also divided women into groups based on whether their ACE score was ≤3 or ≥4 due to evidence that individuals who have experienced ≥4 ACEs are at greatest risk for physical and mental health conditions. Among our participants, 80% of women with an ACE score ≥4 (n=10) had PreE while only 35.3% of women with a score ≤3 (n=68) developed the condition (P=0.01). As well, the odds of having PreE were higher in those with ACE scores ≥4, compared with those with scores ≤3 (OR= 7.34; 95% CI = 1.44, 37.33). In a subset of participants, scores were available from EPDS, survey that identifies women who have postpartum depression 6 weeks after birth, and from the PHQ-9, another assessment for depression. Among our participants, the average EPDS score was higher in women with PreE than women without PreE (6.38, n=21 vs. 3.71, n=42 P=0.01), indicating more severe symptoms of postpartum depression in women who also had PreE. In addition, the average PHQ-9 score among women with PreE was higher than that of women without PreE (3.71, n=15 vs 1.86, n=37 P=.02) with a higher score indicating more severe depression. The average PHQ-9 score was also higher in women who had ACE scores ≥4 than women with scores ≤3 (4.00, n=4 vs. 2.27, n=48 P=.01) indicating that women with more adverse childhood events were more likely to experience depression. Together, these findings indicate that PreE may be associated with adverse events during childhood as well as depression in late pregnancy and/or postpartum.

scholarly journals ADVERSE CHILDHOOD EXPERIENCES REPORTED BY CUSTODIAL GRANDMOTHERS AND THEIR ADOLESCENT GRANDCHILDREN

2019 ◽  
Vol 3 (Supplement_1) ◽  
pp. S283-S283
Author(s):  
Gregory C Smith ◽  
Frank J Infurna ◽  
Britney A Webster ◽  
Megan L Dolbin-MacNab ◽  
Max Crowley ◽  
...  
Keyword(s):  
Adverse Childhood Experiences ◽  
Well Being ◽  
Verbal Abuse ◽  
Physical And Mental Health ◽  
School Problems ◽  
Childhood Experiences ◽  
Standardized Measures ◽  
Adverse Childhood ◽  
Custodial Grandmothers ◽  
Loss Of A Parent

Abstract The Risky Family Model postulates that adverse childhood experiences (ACE) are likely to be encountered across generations within custodial grandfamilies which, in turn, may adversely impact their overall well-being. The present study is a pioneering attempt to examine the patterns of ACEs self-reported by custodial grandmothers (CGM) and adolescent grandchildren (AGC) from the same families, and how their total ACE scores correlate with key physical and mental health outcomes. A total of 129 CGM-ACG dyads recruited for a nationwide RCT study completed separately at baseline the 10-item ACE-CDC and 4 items from the ACE-IQ, as well as various standardized measures of physical and emotional well-being. The most frequent ACEs reported by AGC were loss of a parent (60.5%), verbal abuse (58.1%), bullying by peers (46.5%), and living with someone jailed (45.0%). The predominant ACEs for CGM were bullying by peers (48.8%), verbal abuse (48.1%), living with a mentally ill person (34.1%), being touched sexually (29.5%), and loss of parent (29.5%). Only 10.1% of ACG and 15.5% of CGM reported 0 ACEs, whereas 65.1 % of ACG and 59% of CGM reported > 3 ACEs. For ACG, total ACE scores correlated significantly with externalizing (r=.32) and internalizing (r=.30) difficulties, self-esteem (r= -.28), loneliness (r=.27), school problems (r=.24), and physical health (r= -.26). For CGMs, anxiety (r=.23) and depression (r=.19) only were correlated significantly with total ACEs. We conclude that although both CGM and ACG reported alarmingly high levels of ACEs, different patterns and correlates exist between the generations. [Funded by R01AG054571]

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