ACEs and counter-ACEs: How positive and negative childhood experiences influence adult health.

Aim:The long-term effects of intimate partner violence (IPV) on physical health outcomes and health-related behaviors are underresearched in comparison to the effects on mental health and pregnancy...

The Effect of Intimate Partner Violence on the Physical Health and Health-Related Behaviors of Women: A Systematic Review of the Literature.

Adverse childhood experiences (ACEs) and substance use disorder (SUD): A scoping review.

Importance Associations between adverse childhood experiences (ACEs) and chronic diseases among middle-aged or older Chinese individuals have not been well documented. In addition, whether demographic and socioeconomic characteristics modify any such associations has been underexplored. Objectives To examine associations between ACEs and subsequent chronic diseases and to assess whether age, sex, educational level, annual per capita household expenditure level, and childhood economic hardship modify these associations. Design, Setting, and Participants This population-based cross-sectional study used data from the China Health and Retirement Longitudinal Study (CHARLS), a survey of residents aged 45 years or older in 28 provinces across China; specifically, the study used data from the CHARLS life history survey conducted from June 1 to December 31, 2014, and a CHARLS follow-up health survey conducted from July 1 to September 30, 2015. The study population included 11 972 respondents aged 45 years or older who had data on at least 1 of 14 specified chronic diseases and information on all 12 of the ACE indicators included in this study. Data analysis was performed from December 1 to 30, 2020. Exposures Any of 12 ACEs (physical abuse, emotional neglect, household substance abuse, household mental illness, domestic violence, incarcerated household member, parental separation or divorce, unsafe neighborhood, bullying, parental death, sibling death, and parental disability), measured by indicators on a questionnaire. The number of ACEs per participant was summed and categorized into 1 of 5 cumulative-score groups: 0, 1, 2, 3, and 4 or more. Main Outcomes and Measures Hypertension, dyslipidemia, diabetes, heart disease, stroke, chronic lung disease, asthma, liver disease, cancer, digestive disease, kidney disease, arthritis, psychiatric disease, and memory-related disease were defined by self-reported physician diagnoses or in combination with health assessment and medication data. Multimorbidity was defined as the presence of 2 or more of these 14 chronic diseases. Logistic regression models were used to assess associations of the 12 ACEs with the 14 chronic diseases and with multimorbidity. Modification of the associations by demographic and socioeconomic characteristics was assessed by stratified analyses and tests for interaction. Results Of the 11 972 individuals included (mean [SD] age, 59.85 [9.56] years; 6181 [51.6%] were females), 80.9% had been exposed to at least 1 ACE and 18.0% reported exposure to 4 or more ACEs. Compared with those without ACE exposure, participants who experienced 4 or more ACEs had increased risks of dyslipidemia, chronic lung disease, asthma, liver disease, digestive disease, kidney disease, arthritis, psychiatric disease, memory-related disease, and multimorbidity. The estimated odds ratios (ORs) ranged from 1.27 (95% CI, 1.02-1.59) for dyslipidemia to 2.59 (95% CI, 2.16-3.11) for digestive disease. A dose-response association was also observed between the number of ACEs and the risk of most of the chronic diseases (excluding hypertension, diabetes, and cancer) (eg, chronic lung disease for ≥4 ACEs vs none: OR, 2.01; 95% CI, 1.59-2.55;P  Conclusions and Relevance In this population-based, cross-sectional study of adults in China, exposure to ACEs was associated with higher risks of chronic diseases regardless of demographic and socioeconomic characteristics during childhood or adulthood. These findings suggest a need to prevent ACEs and a need for a universal life-course public health strategy to reduce potential adverse health outcomes later in life among individuals who experience them.

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Adverse Childhood Experiences and Subsequent Chronic Diseases Among Middle-aged or Older Adults in China and Associations With Demographic and Socioeconomic Characteristics

Psychometric evaluation of the Adverse Childhood Experience International Questionnaire (ACE-IQ) in Malawian adolescents

Background Adverse childhood experiences (ACEs) have been associated with poor health status later in life. The objective of the present study was to examine the relationship between ACEs and health-related behaviors, chronic diseases, and mental health in adults. Methods A cross-sectional study was performed with 1501 residents of Macheng, China. The ACE International Questionnaire (ACE-IQ) was used to assess ACEs, including psychological, physical, and sexual forms of abuse, as well as household dysfunction. The main outcome variables were lifetime drinking status, lifetime smoking status, chronic diseases, depression, and posttraumatic stress disorder. Multiple logistic regression models were used to examine the associations between overall ACE score and individual ACE component scores and risk behaviors/comorbidities in adulthood after controlling for potential confounders. Results A total of 66.2% of participants reported at least one ACE, and 5.93% reported four or more ACEs. Increased ACE scores were associated with increased risks of drinking (adjusted odds ratio [AOR] = 1.09, 95% confidence intervals [CI]: 1.00-1.09), chronic disease (AOR = 1.17, 95% CI: 1.06-1.28), depression (AOR = 1.37, 95% CI: 1.27-1.48), and posttraumatic stress disorder (AOR = 1.32, 95% CI: 1.23-1.42) in adulthood. After adjusting for confounding factors, the individual ACE components had different impacts on risk behavior and health, particularly on poor mental health outcomes in adulthood. Conclusions ACEs during childhood were significantly associated with risk behaviors and poor health outcomes in adulthood, and different ACE components had different long-term effects on health outcomes in adulthood.

/pdf/associations-between-adverse-childhood-experiences-and-4vubi9t17c.pdf

Associations between adverse childhood experiences and health outcomes in adults aged 18-59 years

This study aimed to investigate the effect of PRECEDE-PROCEED-Model-based health education on the life quality of patients with gastric cancer after surgery. Also, the effect of this model was evaluated on 5-HTT gene expression as a gene related to depression. For this purpose, a total of 32 gastric cancer patients who were hospitalized in this hospital between March 2019 and September 2020 were enrolled in this study after surgery and, according to the time of admission, were divided into the control group and observation group, with 16 patients in each group. Patients in the control group were nursed regularly, while those in the observation group, in addition to the regular nursing, would receive the PRECEDE-PROCEED-Model-based health education. Post-surgery life quality of patients in two groups was compared from the following aspects: Rehabilitation process, pain assessment, rate of complications and The Short-Form (SF-36) Health Survey. The expression of the 5-HTT gene was performed by the Real-time qPCR technique. The results of this study showed that after surgery, the extubation time and the time of hospital discharge of patients in the observation group were all earlier than those in the control group, while the score of pain assessment and rate of complication was much lower in the observation group, and the SF-36 score of patients was much higher (all P < 0.05). The results of 5-HTT gene expression showed that there was no significant difference between the control and observation groups before the intervention. But one month after the intervention, gene expression in the observation group was significantly reduced compared to the control group (p <0.01). This significant decrease was also seen two months after the intervention (p <0.05). As mentioned before, the expression of the 5-HTT gene increases during the depression, therefore improvement of the patient's condition and quality of life decreased the expression of this gene. Hence, PRECEDE-PROCEED-Model-Based Health Education plays an influential role in reducing the expression of this gene. However, the passage of time has not been ineffective in lowering 5-HTT expression. In general, PRECEDE-PROCEED-Model-based health education could help patients establish a good system of health knowledge, which could encourage the patients to avoid the negative mood, optimize the rehabilitation process, improve the post-surgery rehabilitation and, finally, ameliorate the life quality of patients after surgery.

Effect of PRECEDE-PROCEED-Model-Based Health Education on the Life Quality and 5-HTT Gene Expression of Patients with Gastric Cancer after Surgery.

Association between BDNF gene polymorphisms and attention deficit hyperactivity disorder in school-aged children in Wuhan, China.

Intimate partner violence (IPV) among pregnant women constitutes a global public health problem and a potential risk factor for adverse maternal and fetal outcomes. The present study aimed to examine the associations among IPV during pregnancy, prenatal depression, and adverse birth outcomes in Wuhan, China. A cross-sectional study was performed from April 2013 to March 2014 in Wuhan, China. Sociodemographic characteristics, IPV during pregnancy, and depressive symptoms during pregnancy were assessed in the third trimester of pregnancy. Birth outcomes were collected after delivery using medical records. Chi-square tests and logistic regression analysis were used to examine the association between IPV and prenatal depression, as well as the association between IPV combined with prenatal depression and adverse birth outcomes. After adjustment for covariates, there was a statistically significant association between IPV during pregnancy and prenatal depression (adjusted odds ratio [aOR] = 2.50, 95% confidence interval [CI]: 1.60–3.90). IPV during pregnancy (aOR = 1.67, 95% CI: 1.08–2.56) and prenatal depression (aOR = 1.72, 95% CI: 1.11–2.68) were significantly associated with adverse birth outcomes. Women experiencing psychological abuse had a significantly higher odds of prenatal depression (aOR = 2.04, 95% CI: 1.19–3.49) and of adverse birth outcomes (aOR = 2.13, 95% CI: 1.08–2.58), compared with women who did not experience IPV and prenatal depression. IPV during pregnancy and prenatal depression were significantly associated with adverse birth outcomes, after adjustment for socio-demographic and behavior factors. The findings suggest that early recognition of IPV and prenatal depression during antenatal care may protect pregnant women and improve birth outcomes.

/pdf/association-of-intimate-partner-violence-during-pregnancy-385skh4q6m.pdf

Association of intimate partner violence during pregnancy, prenatal depression, and adverse birth outcomes in Wuhan, China.

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Associations between adverse childhood experiences and health outcomes in adults aged 18-59 years

Effect of PRECEDE-PROCEED-Model-Based Health Education on the Life Quality and 5-HTT Gene Expression of Patients with Gastric Cancer after Surgery.

Association between BDNF gene polymorphisms and attention deficit hyperactivity disorder in school-aged children in Wuhan, China.

Association of intimate partner violence during pregnancy, prenatal depression, and adverse birth outcomes in Wuhan, China.