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Adverse childhood experiences among youth from high-achieving schools: Appraising vulnerability processes toward fostering resilience

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Abstract

Among youth from high-achieving schools, adverse childhood experiences (ACEs) were examined in relation to (a) internalizing and externalizing symptoms in adolescence (n = 527), and (b) symptoms plus psychiatric diagnoses-based on multiple annual interviews-in adulthood (n = 316). Also examined were associations for a "Proxy ACEs" (P-ACEs) measure, containing items similar to those on standard ACEs measures without reference to abuse or neglect. Rates of ACEs were comparable with those in other studies; most commonly endorsed were perceived parental depression followed by aspects of emotional neglect. Groups exposed to zero, 1, 2, 3, and 4+ ACEs differed on symptoms in adulthood, with small to moderate effect sizes; in parallel comparisons of P-ACEs groups on Grade 12 symptoms, differences had large effect sizes. In relation to psychiatric diagnoses, comparisons with the zero ACEs group showed that groups with 1, 2, 3 ACEs, versus 4+ ACES, respectively, had twofold and over fivefold greater odds of having any lifetime diagnosis. The odds for internalizing diagnoses specifically were 2-6 times greater for individuals with 1, 2, and 3 ACEs, and 12 times greater for those reporting 4 ACEs. Remarkably, Grade 12 reports of 2, 3, and 4+ P-ACEs were linked to 2-3 times greater odds of a psychiatric disorder in adulthood, and 3-6 times greater odds for internalizing diagnoses specifically. In the future, assessments of ACEs and P-ACEs could facilitate early detection of problems among HAS students, informing interventions to mitigate vulnerability processes and promote resilience among these youth and their families. (PsycInfo Database Record (c) 2021 APA, all rights reserved).

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... Systemic processes that play out at the individual level could accumulate to impact pertinent outcomes in adulthood and old age (Dannefer, 2003;Ferraro & Morton, 2018). For example, reporting more adversities early in life is associated with Downloaded from https://academic.oup.com/psychsocgerontology/advance-article/doi/10.1093/geronb/gbab230/6461068 by guest on 14 December 2021 A c c e p t e d M a n u s c r i p t increased risk of psychopathology and disease onset across the adult lifespan (Felitti et al., 1998;Luthar, Ciciolla, & Suh, 2021). In the case of lifetime adversity, the accumulation of adversities across the life course could increase one"s vulnerabilities to additional setbacks, such as our focus of examining changes in psychological well-being when monthly adversity is experienced. ...
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Objective: Our objective is to examine whether lifetime adversity has either a 'steeling effect' or 'cumulative disadvantage effect' on the consequences of monthly adversity on psychological well-being in middle-aged adults. An exploratory step was to examine whether such associations differed based on the domain of adversity (personal, family/friend, bereavement, social-environmental, and relationship). Method: Multilevel modeling was applied to data from a sample of participants in midlife (n = 358, ages 50-65, 54% women) who were assessed monthly for two years. Results: Lifetime adversity did not show steeling effects, but instead appeared to exacerbate the impact of monthly adversity on psychological well-being, indicating cumulative disadvantage. On months where an adversity was experienced, on average, individuals who reported more lifetime adversity showed stronger increases in depressive symptoms, anxiety, and negative affect and decreases in positive affect. There was limited evidence to suggest for steeling effects for life satisfaction. Reporting adversity in the personal, bereavement, social-environmental, and relationship domains showed the strongest associations with psychological well-being. Discussion: Our discussion focuses on how lifetime adversity showed a cumulative disadvantage effect on the consequences of monthly adversity on psychological well-being. We also elaborate on future directions for research that include other conceptualizations of adversity and research to examine mechanisms underlying this relationship.
... Veterans, particularly female veterans, are an important and understudied population and serve as the focus for study by Blosnich et al. (2021) about the associations between ACEs and suicidal ideation. Luthar et al. (2021) looks beyond more traditional target populations to examine a recently identified Group at risk for ACEsyouth from high-achieving schools. ...
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Adverse childhood experiences (ACEs) detrimentally affect health outcomes in childhood, adolescence, and adulthood. Over the past 2 decades, the recognition of ACEs by scientists and professionals across disciplines, policymakers, and the public has evolved and expanded. Although the initial articulation of ACEs in Felitti et al.'s landmark study has formed the basis of subsequent investigations on the long-term impact of childhood adversities on health and health risk behaviors, a wider public health framework, inclusive of psychology and other social sciences, also shapes current conceptualizations, research, practice, and policies. This article provides an overview of the special issue Adverse Childhood Experiences: Translating Research to Action. Given the rapid expansion and widespread application of ACEs, this special issue was developed to articulate critical concepts, to demonstrate the significance and relevance of psychological research and practice, and to catalyze further efforts to develop effective programs and policies informed by science. The 15 articles included reflect the continuum of critical work being conducted in research, practice, intervention and prevention programs, and public policy and serve to synthesize the growing body of empirical evidence. The overarching themes that emerged are framed as 3 essential questions: (a) How broadly should ACEs be defined?, (b) How should ACEs be assessed?, and (c) How can ACEs science translate into high quality services? As illustrated in these articles, policy and practice applications deriving from psychology as a hub science can substantially benefit the health and mental health of children, adolescents, and adults. (PsycInfo Database Record (c) 2021 APA, all rights reserved).
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Excessive pressures to excel, generally in affluent contexts, are now listed among the top 4 "high risk" factors for adolescents' mental health, along with exposure to poverty, trauma, and discrimination. Multiple studies of high-achieving school (HAS) cohorts have shown elevated rates of serious symptoms relative to norms, with corroborating evidence from other research using diverse designs. Grounded in theories on resilience and ecological influences in development, a conceptual model is presented here on major risk and protective processes implicated in unrelenting achievement pressures facing HAS youth. These include forces at the macrolevel, including economic and technological changes that have led to the "middle class squeeze," and proximal influences involving the family, peers, schools, and communities. Also considered are potential directions for future interventions, with precautions about some practices that are currently widespread in HAS contexts. In the years ahead, any meaningful reductions in the high distress of HAS youth will require collaborations among all stakeholders, with parents and educators targeting the specific areas that must be prioritized in their own communities. Leaders in higher education and social policy could also help in beginning to curtail this problem, which is truly becoming an epidemic among today's youth. (PsycINFO Database Record (c) 2019 APA, all rights reserved).
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Marriages are often characterized by their positive and negative features in terms of whether they elicit feelings of satisfaction and happiness or conflict and negativity. Although research has examined the development of marital happiness, less is known about the development of negativity among married couples. We examined how marital tension (i.e., feelings of tension, resentment, irritation) develops within couples over time and whether marital tension has unique implications for divorce. Specifically, we examined marital tension among husbands and wives within the same couples from the first to the sixteenth year of marriage, as well as links between marital tension and divorce. Participants included 355 couples assessed in years 1, 2, 3, 4, 7, and 16 of marriage. Multilevel models revealed that wives reported greater marital tension than husbands. Marital tension increased over time among both husbands and wives, with a greater increase among husbands. Couples were more likely to divorce when wives reported higher marital tension, a greater increase in marital tension, and greater cumulative marital tension. Findings are consistent with the emergent distress model of marriage, but indicate that despite the greater increases in marital tension among husbands, wives' increased marital tension over the course of marriage is more consistently associated with divorce. (PsycINFO Database Record
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Although it is widely acknowledged that domestic violence (DV) can happen to anyone, there is scant research on affluent women's DV experiences. Using grounded theory, the present study examined how affluent mothers managed secrecy and disclosure of DV in the context of their community. Data consisted of interviews with 10 mothers and 17 service providers from one affluent community. The process of managing secrecy and disclosure of DV was nonlinear, ongoing, and strongly influenced by community culture and familial status. Mothers' secrecy and disclosure decisions (i.e., how and when mothers disclosed) and experiences (i.e., the type of responses they received upon disclosure) varied depending on whether they bought in or opted out of the culture of affluence during marriage. The resulting grounded theory has implications for future research on DV in affluent families and the broader literature on secrecy and DV disclosure.
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Children who have experienced environmental adversity—such as abuse, neglect, or poverty—are more likely to develop physical and mental health problems, perform poorly at school, and have difficulties in social relationships than children who have not encountered adversity. What is less clear is how and why adverse early experiences exert such a profound influence on children’s development. Identifying developmental processes that are disrupted by adverse early environments is the key to developing better intervention strategies for children who have experienced adversity. Yet much existing research relies on a cumulative-risk approach that is unlikely to reveal these mechanisms. This approach tallies the number of distinct adversities experienced to create a risk score. This risk score fails to distinguish between distinct types of environmental experiences, implicitly assuming that very different experiences influence development through the same underlying mechanisms. We advance an alternative model. This novel approach conceptualizes adversity along distinct dimensions, emphasizes the central role of learning mechanisms, and distinguishes between different forms of adversity that might influence learning in distinct ways. A key advantage of this approach is that learning mechanisms provide clear targets for interventions aimed at preventing negative developmental outcomes in children who have experienced adversity.
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Objective: While the increased risk of psychopathology in the biological offspring of depressed parents has been widely replicated, the long-term outcome through their full age of risk is less known. The authors present a 30-year follow-up of biological offspring (mean age=47 years) of depressed (high-risk) and nondepressed (low-risk) parents. Method: One hundred forty-seven offspring of moderately to severely depressed or nondepressed parents selected from the same community were followed for up to 30 years. Diagnostic assessments were conducted blind to parents' clinical status. Final diagnoses were made by a blinded M.D. or Ph.D. evaluator. Results: The risk for major depression was approximately three times as high in the high-risk offspring. The period of highest risk for first onset was between ages 15 and 25 in both groups. Prepubertal onsets were uncommon, but high-risk offspring had over 10-fold increased risk. The early onset of major depression seen in the offspring of depressed parents was not offset by later first onsets in the low-risk group as they matured. The increased rates of major depression in the high-risk group were largely accounted for by the early onsets, but later recurrences in the high-risk group were significantly increased. The high-risk offspring continue to have overall poorer functioning and receive more treatment for emotional problems. There was increased mortality in the high-risk group (5.5% compared with 2.5%) due to unnatural causes, with a nearly 8-year difference in the mean age at death (38.8 years compared with 46.5 years). Conclusions: The offspring of depressed parents remain at high risk for depression, morbidity, and mortality that persists into their middle years. While adolescence is the major period of onset for major depression in both risk groups, it is the offspring with family history who go on to have recurrences and a poor outcome as they mature. In the era of personalized medicine, until a more biologically based understanding of individual risk is found, a simple family history assessment of major depression as part of clinical care can be a predictor of individuals at long-term risk.
Article
Marital attributions-that is, causal inferences and explanations spouses make about their partners' behavior-have been implicated as predictors of relationship functioning. Extending previous work, we examined marital attributions as a moderator of the link between marital conflict and depressive symptoms 1 year later. Participants were 284 couples who reported on marital attributions and depressive symptoms. Couples also engaged in a videotaped marital conflict interaction, which was later coded for specific conflict behaviors. The results showed that husbands' and wives' marital attributions about their partner moderated relations between marital conflict behavior and later depressive symptoms, controlling for global marital sentiments. For husbands, positive behavior and affect during marital conflict predicted a decrease in depressive symptoms, but only for husbands' who made low levels of responsibility and causal attributions about their wives. Wives' causal attributions about their partner also moderated relations between positive behavior and affect during marital conflict and husbands' later depressive symptoms. Reflecting an unexpected finding, negative behavior and affect during marital conflict predicted increases in wives' depressive symptoms, but only for wives who made low levels of responsibility attributions about their partner. The findings suggest that, for husbands, low levels of negative marital attributions for spouses may be protective, strengthening the positive effect of constructive conflict behaviors for their mental health, whereas for wives low levels of responsibility attributions about their spouse may be a risk factor, exacerbating the negative effect of negative marital conflict behaviors on their later depressive symptoms. (PsycINFO Database Record
Article
This article considers the understudied phenomenon of children’s organized leisure as it relates to the division of labor in the family. Using both quantitative and qualitative data, we first ask whether the labor entailed by children’s organized leisure is divided evenly between mothers and fathers. Both data sets indicate that this is not the case, with the majority of the work falling to mothers; they also indicate that at least some employed mothers face a tradeoff between time devoted to paid work and time devoted to facilitating their children’s leisure. Subsequently, we consider key qualitative aspects of these leisure activities, including deadline sensitivity, authority over scheduling, and degree of predictability. These factors, we find, serve to exacerbate the inequity of the allocation of responsibility between mothers and fathers. We conclude by suggesting that organized leisure has become an important part of the familial landscape and thus warrants further attention. We also suggest that research on the gender division of labor would be enhanced in important ways by greater attention to qualitative dimensions of time use. Researchers should not simply assume that “an hour is an hour.”
Article
There is a burgeoning and varied literature examining the associations between parental factors and depression or anxiety disorders in children. However, there is hitherto no systematic review of this complex literature with a focus on the 5-11 years age range, when there is a steep increase in onset of these disorders. Furthermore, to facilitate the application of the evidence in prevention, a focus on modifiable factors is required. Employing the PRISMA method, we conducted a systematic review of parental factors associated with anxiety, depression, and internalizing problems in children which parents can potentially modify. We identified 141 articles altogether, with 53 examining anxiety, 50 examining depression, and 70 examining internalizing outcomes. Stouffer׳s method of combining p-values was used to determine whether associations between variables were reliable, and meta-analyses were conducted with a subset of eligible studies to estimate the mean effect sizes of associations between each parental factor and outcome. Limitations include sacrificing micro-level detail for a macro-level synthesis of the literature, the lack of generalizability across cultures, and the inability to conduct a meta-analysis on all included studies. Parental factors with a sound evidence base indicating increased risk for both depression and internalizing problems include more inter-parental conflict and aversiveness; and for internalizing outcomes additionally, they include less warmth and more abusive parenting and over-involvement. No sound evidence linking any parental factor with anxiety outcomes was found. Copyright © 2015 Elsevier B.V. All rights reserved.
Article
Perfectionism is a major diagnostic criterion for one DSM-III diagnosis, and it has been hypothesized to play a major role in a wide variety of psychopathologies. Yet there is no precise definition of, and there is a paucity of research on, this construct. Based on what has been theorized about perfectionism, a multidimensional measure was developed and several hypotheses regarding the nature of perfectionism were tested in four separate studies. The major dimension of this measure was excessive concern over making mistakes. Five other dimensions were identified, including high personal standards, the perception of high parental expectations, the perception of high parental criticism, the doubting of the quality of one's actions, and a preference for order and organization. Perfectionism and certain of its subscales were correlated with a wide variety of psychopathological symptoms. There was also an association between perfectionism and procrastination. Several subscales of the Multidimensional Perfectionism Scale (MPS), personal standards and organization, were associated with positive achievement striving and work habits. The MPS was highly correlated with one of the existing measures of perfectionism. Two other existing measures were only moderately correlated with the MPS and with each other. Future studies of perfectionism should take into account the multidimensional nature of the construct.
Article
Although significant associations of childhood adversities (CAs) with adult mental disorders have been documented consistently in epidemiological surveys, these studies generally have examined only 1 CA per study. Because CAs are highly clustered, this approach results in overestimating the importance of individual CAs. Multivariate CA studies have been based on insufficiently complex models. To examine the joint associations of 12 retrospectively reported CAs with the first onset of DSM-IV disorders in the National Comorbidity Survey Replication using substantively complex multivariate models. Cross-sectional community survey with retrospective reports of CAs and lifetime DSM-IV disorders. Household population in the United States. Nationally representative sample of 9282 adults. Lifetime prevalences of 20 DSM-IV anxiety, mood, disruptive behavior, and substance use disorders assessed using the Composite International Diagnostic Interview. The CAs studied were highly prevalent and intercorrelated. The CAs in a maladaptive family functioning (MFF) cluster (parental mental illness, substance abuse disorder, and criminality; family violence; physical abuse; sexual abuse; and neglect) were the strongest correlates of disorder onset. The best-fitting model included terms for each type of CA, number of MFF CAs, and number of other CAs. Multiple MFF CAs had significant subadditive associations with disorder onset. Little specificity was found for particular CAs with particular disorders. Associations declined in magnitude with life course stage and number of previous lifetime disorders but increased with length of recall. Simulations suggest that CAs are associated with 44.6% of all childhood-onset disorders and with 25.9% to 32.0% of later-onset disorders. The fact that associations increased with length of recall raises the possibility of recall bias inflating estimates. Even considering this, the results suggest that CAs have powerful and often subadditive associations with the onset of many types of largely primary mental disorders throughout the life course.
Article
Adverse childhood events (ACEs) are associated with negative health outcomes. We examined ACEs as risk factors for substance dependence (SD) and the mediating effects of mood and anxiety disorders on the relations between ACEs and SD risk. We compared early life experiences in 2061 individuals with a lifetime diagnosis of alcohol, cocaine, or opioid dependence and 449 controls. Diagnostic and ACE data were obtained using the Semi-Structured Assessment for Drug Dependence and Alcoholism. Childhood abuse or exposure to violent crime was positively related to the number of lifetime mood and anxiety disorders and to SD risk. Mood and anxiety disorders had their first onset a mean of nearly 3 years before the first SD diagnosis and partially mediated the effect of ACEs on SD risk. ACEs appear to contribute additively to the risk of SD, with mood and anxiety disorders in the causal path for a portion of this risk. The identification and effective treatment of mood and anxiety disorders associated with ACEs could reduce the risk of developing SD.
Article
In order to find out whether parents and teachers report depressive symptoms in children with self-reported depression and which features are connected with sought psychiatric care, a sample of 5682 prepubertal children was assessed with the Children's Depression Inventory (CDI), the Rutter A2 scale (RA) and Rutter B2 scale (RB). In stepwise regression analysis of parent report, depressed mood, unpopularity, social withdrawal, disobedience, inattentiveness, and stealing were associated with high CDI scores. The items of the teacher report associated with high CDI scores included poor school performance, restlessness, somatic complaints, unresponsiveness, being bullied, and absenteeism from school. Although the parents and teachers readily saw and reported depressive symptoms in children, only for a small minority of children with multiple depressive symptoms had psychiatric care been sought or even considered. The symptoms associated with sought psychiatric care for depressed children were somatic (soiling, asthma) and behavioural (disobedient, restless). The results indicate that a large number of children with multiple depressive symptoms are left without necessary psychiatric assessment and help.
Article
The relationship of health risk behavior and disease in adulthood to the breadth of exposure to childhood emotional, physical, or sexual abuse, and household dysfunction during childhood has not previously been described. A questionnaire about adverse childhood experiences was mailed to 13,494 adults who had completed a standardized medical evaluation at a large HMO; 9,508 (70.5%) responded. Seven categories of adverse childhood experiences were studied: psychological, physical, or sexual abuse; violence against mother; or living with household members who were substance abusers, mentally ill or suicidal, or ever imprisoned. The number of categories of these adverse childhood experiences was then compared to measures of adult risk behavior, health status, and disease. Logistic regression was used to adjust for effects of demographic factors on the association between the cumulative number of categories of childhood exposures (range: 0-7) and risk factors for the leading causes of death in adult life. More than half of respondents reported at least one, and one-fourth reported > or = 2 categories of childhood exposures. We found a graded relationship between the number of categories of childhood exposure and each of the adult health risk behaviors and diseases that were studied (P < .001). Persons who had experienced four or more categories of childhood exposure, compared to those who had experienced none, had 4- to 12-fold increased health risks for alcoholism, drug abuse, depression, and suicide attempt; a 2- to 4-fold increase in smoking, poor self-rated health, > or = 50 sexual intercourse partners, and sexually transmitted disease; and 1.4- to 1.6-fold increase in physical inactivity and severe obesity. The number of categories of adverse childhood exposures showed a graded relationship to the presence of adult diseases including ischemic heart disease, cancer, chronic lung disease, skeletal fractures, and liver disease. The seven categories of adverse childhood experiences were strongly interrelated and persons with multiple categories of childhood exposure were likely to have multiple health risk factors later in life. We found a strong graded relationship between the breadth of exposure to abuse or household dysfunction during childhood and multiple risk factors for several of the leading causes of death in adults.
The young adult self-report
  • T M Achenbach
Achenbach, T. M. (1990). The young adult self-report. University of Vermont, Department of Psychiatry.
Manual for the ASEBA schoolage forms & profiles: An integrated system of multi-informant assessment
  • T M Achenbach
  • L Rescorla
Achenbach, T. M., & Rescorla, L. (2001). Manual for the ASEBA schoolage forms & profiles: An integrated system of multi-informant assessment. University of Vermont, Department of Psychiatry.
Issue Brief: Adverse childhood experiences among U.S. children. Child and Adolescent Health Measurement Initiative
  • C D Bethell
  • M B Davis
  • N Gombojav
  • S Stumbo
  • K Powers
Bethell, C. D., Davis, M. B., Gombojav, N., Stumbo, S., & Powers, K. (2017). Issue Brief: Adverse childhood experiences among U.S. children. Child and Adolescent Health Measurement Initiative, Johns Hopkins Bloomberg School of Public Health. https://www.publicschoolsfirstnc.org/wp-content/uploads/ 2018/08/ACEs-Fact-Sheet.pdf
The psychology of mattering: Understanding the human need to be significant
  • G Flett
Flett, G. (2018). The psychology of mattering: Understanding the human need to be significant. Academic Press.
Adolescent wellness: Current perspectives and future opportunities in research, policy, and practice: A learning report
  • M B Geisz
  • M Nakashian
Geisz, M. B., & Nakashian, M. (2018). Adolescent wellness: Current perspectives and future opportunities in research, policy, and practice: A learning report. https://www.rwjf.org/content/dam/farm/reports/ issue_briefs/2018/rwjf445935/subassets/rwjf445935_1
Teenage depression: If a parent doesn't get treatment for a child
  • M Shapiro
Shapiro, M. (2018). Teenage depression: If a parent doesn't get treatment for a child, is that abuse? http://theconversation.com/teenagedepression-if-a-parent-doesnt-get-treatment-for-a-child-is-that-abuse-95353
The MOMS Partnership: Reducing maternal depressive symptoms through a place-based, community partnered approach
  • M V Smith
  • L Callinan
  • C Posner
  • M Ciargello
  • S Holmes
Smith, M. V., Callinan, L., Posner, C., Ciargello, M., & Holmes, S. (in press). The MOMS Partnership: Reducing maternal depressive symptoms through a place-based, community partnered approach. Health Affairs.