The relationship between adverse childhood experiences,health and life satisfaction in adults with care experience: The mediating role of attachment

Adverse childhood experiences (ACEs) are associated with a plethora of negative outcomes. Research has also found that adults who were separated from parental care and lived in alternative care settings during childhood have high levels of ACEs and are more likely to have poor outcomes. A growing body of research has supported the importance of attachment as a mechanism underlying the relationship between ACEs and adult wellbeing. However, little work has examined the role that attachment may play in the outcomes of adults who resided in residential and foster care during childhood. The current study examined the role of attachment avoidance and anxiety in the associations between ACEs and mental health, physical health, and life satisfaction in a sample of 529 adults with alternative care experience from 11 nations. Attachment avoidance partially mediated the relationship between ACEs and life satisfaction, mental health, and physical health. Attachment anxiety partially mediated the relationship between ACEs and life satisfaction and mental health, but not physical health. Taken together, the present study suggests that both attachment anxiety and avoidance play important, but unique, roles in understanding the relationship between ACEs and health and wellbeing for adults with care experience. Implications and limitations are discussed.     

Factors Associated with Suicidal Ideation Among Women Abused in Intimate Partner Relationships

This study examines factors associated with suicidal ideation among women abused in intimate partner relationships. Data were collected from the case records of 95 women screened upon in‐person contact with admissions workers in a domestic violence shelter in one Midwestern state. Forty‐three percent of the women reported suicidal ideation as significantly associated with childhood sexual abuse, childhood physical abuse, and adulthood intimate partner abuse lasting fewer than 12 months in duration. The results have policy and practice implications for those interested in the mental health needs of women abused in childhood and adulthood. Implications for research are presented that more precisely identify how the effects of past and current traumatic experiences intersect and contribute to suicidal ideation among women abused in intimate relationships.     

Adverse Childhood Experiences and Substance Use History among Vulnerable Older Adults Living in Public Housing

ABSTRACT

Previous research shows strong correlations between adverse childhood experiences (ACE) and later life health. The current study examines the relationship between ACEs and substance use among older adults living in public housing. Results show that about one-third of participants had four or more ACEs, and ACE score predicted likelihood of substance use history. Over half of older adults with four or more ACEs experienced substance abuse in their lifetime compared to one out of ten older adults with less than four ACEs. Findings shed light on a vulnerable group and point to next steps in research and practice.     

Violence Across the Lifespan: Interconnections Among Forms of Abuse as Described by Marginalized Canadian Elders and their Care-givers

Elder abuse is recognized as a major problem, with profoundeffects on the health and quality of life of older persons.In our aging population, elder abuse represents an escalatingclinical issue for social workers and health care professionalswho provide care to older people. A major gap in our examinationof elder abuse is the potential contribution and applicationof knowledge developed within research derived from other formsof family violence. This paper explores the interconnectionsamong various forms of violence across the lifespan, and theexperiences voiced by marginalized elders and their care providers.We interviewed seventy-seven rarely consulted older adults andforty-three formal and informal care-givers of older adultsin focus groups in Ontario and Alberta, Canada. Study findingsrevealed four major themes that describe interconnections amongtypes of abuse: (i) intergenerational cycles of abuse; (ii)violence across the lifespan; (iii) exposure to multiple subtypesof elder abuse; and (iv) ongoing spouse abuse that shifted intoelder abuse. The results from this study indicate that victimsoften ‘suffer in silence’ and cultural factors,ageism and gender are ubiquitous to elder abuse. Recommendationsto reduce elder abuse include education, formal and informalsupports and services.     

A Trauma-Based Group Intervention for Incarcerated Girls

Girls are becoming involved in the juvenile justice system at a remarkable rate. As a result, the juvenile justice system must become more responsive to their physical, mental, and educational needs. Many of these girls have been victims of childhood emotional, sexual, or physical abuse resulting in serious mental health problems. This article describes a psycho-educational group intervention designed for adolescent girls involved in the juvenile justice system that have been affected by childhood abuse. The intervention takes place in a residential program for delinquent girls and is a voluntary group. The psycho-education format allows for the participants to gain information about what abuse is and what the impact of abuse can be on their thoughts and actions. The group format provides a supportive environment that promotes group curative factors and mutual aid.     

Practitioner accounts of responding to parent abuse – a case study in ad hoc delivery,perverse outcomes and a policy silence

Parent abuse is becoming recognized as a serious problem in some families. It can have a damaging impact on physical and mental health, family relationships and employment and has been found to be implicated in other past, current and future forms of family abuse and violence. For this reason, many frontline practitioners who work with troubled families frequently find incidents of parent abuse in their caseloads, but we know little of how they respond to it. This study used in‐depth interviews with nine practitioners who work in a range of agencies in one large county in England and explored how they each identify, conceptualize, explain and respond to parent abuse. In a context where there is no national guidance regarding how agencies should respond to this problem, this study finds that practitioners must ‘make do’ without appropriate resources or policy guidance to help them. The study concludes with suggestions for change for the benefit of families who seek support but who currently find little effective response.     

FILIPINA-AUSTRALIAN MARRIAGES: FURTHER PERSPECTIVES ON SPOUSAL VIOLENCE

In this study 61 Filipinos drawn from rural and regional towns reported that they were generally happily married and were subjected infrequently to physical violence in their marriages, although there was evidence of higher levels of abuse in the form of constraints on personal freedom, access to money and verbal criticism. The Filipino cultural value of amor propio (sense of honour or personal dignity) and Filipinas' experience of spousal abuse in their family of origin best predicted their anticipation of reporting spousal abuse and separating from or retaliating against an abusive partner. This provides some support for cultural value and inter generational transfer explanations of response to spousal abuse.     

Changes in flourishing from adolescence to young adulthood: An 8-year follow-up

Most research on mental health among adolescents and young adults concentrates on understanding mental illness. However, mental health is more than the absence of mental illness. Among adolescents and young adults, positive mental health—a combination of emotional, social and psychological well-being—is related to higher prosocial behaviour, school integration and self-concept. However, much of the research on positive mental health among young adults has been with college students. Limited research has examined the presence and correlates of positive mental health, or flourishing, among a nationally representative sample of US young adults. This study extended from another researcher's original examination of positive mental health among US adolescents to describe the prevalence of flourishing among these same individuals in young adulthood. Our sample included 1090 individuals from the 2011 Panel Study of Income Dynamics Transition into Adulthood Supplement. Univariate and bivariate tests were used to describe the prevalence of flourishing during young adulthood and changes from adolescence to young adulthood. We used multivariable logistic regression to examine the relationships among indicators of healthy development and flourishing. Results suggest that flourishing improved during the transition into young adulthood and that targeting factors like life skills and civic engagement may enhance flourishing.     

Social Context in Mental Health Service Use Among Young Adults

Examining the sources of health communication that young adults with mental health challenges receive regarding service use is critical to curbing the societal concern of unmet mental health needs of this population. Semistructured interviews were conducted with 59 young adults, all of whom were diagnosed with a mood disorder and used public mental health services and additional public systems of care during childhood. Thematic analysis was utilized. Of the 59 participants, 45 nominated at least one supportive adult, with a total of 97 relationships analyzed. Results indicate that the majority of messages came from informal supports (e.g., family) who spoke positively about mental health services. Fewer messages came from formal supports (e.g., professionals). Messages included statements surrounding beliefs toward services, social norms (approval and disapproval), self-efficacy, and image considerations around using services. These findings can suggest ways that mental health service engagement interventions can leverage communication from informal supports. Future research can explore what messages young adults find most influential in persuading them to use mental health care consistently and the relationship between messages and health behavior.     

Are dual and single exposures differently associated with clinical levels of trauma symptoms? Examining physical abuse and witnessing intimate partner violence among young children

A significant portion of children living in the United States have experienced trauma. Informed by the developmental traumatology model, we explored the effects of physical abuse and witnessing intimate partner violence (IPV) on childhood trauma symptoms. This study utilizes a convenience sample of 580 high‐risk children between 3 and 12 years who received services from one‐child advocacy centre during a 12‐month period. We performed a series of binary logistic regression analyses to examine if physical abuse, exposure to IPV, and dual exposure (i.e., both physical abuse and IPV) are distinctly associated with six trauma symptoms, including anxiety, depression, posttraumatic stress (PTS), dissociation, anger, and sexual concerns. The results indicated that dual exposure was predictive of all trauma symptoms, except for dissociation. Additionally, physical abuse was associated with PTS, anger, and sexual concerns, whereas exposure to IPV was associated with depression, PTS, and sexual concerns. Research and implications for practitioners working with young children are discussed.     

Childhood maltreatment among Norwegian drug abusers in treatment

This article reports on the investigation of the correlation between the European Addiction Severity Index (EuropASI) and the Childhood Trauma Questionnaire (CTQ) among 102 Norwegian drug abusers admitted to treatment. The aim of the study is to explore how different types and levels of childhood trauma and social and psychiatric factors, medical situation and experienced family history are interrelated. The study addresses three main questions: 1) What is the prevalence of different kinds of childhood trauma among drug abusers in treatment? 2) Does type or level of maltreatment in childhood predict specific substance abuse problems as adults and/or specific social, psychiatric and medical problems as adults? 3) Do substance abuse problems and mental health problems in the primary family predict different types and levels of childhood maltreatment? Twenty‐five per cent of the total sample was included in the high‐level trauma group and 54% in the intermediate‐level group. Females had significantly higher scores than males in all types of childhood trauma. The strongest correlations were found between childhood trauma and lifetime psychiatric problems and psychiatric status during the last 30 days before admission for treatment. More research, and especially prospective studies, is needed to clarify the importance of parents' substance abuse and psychiatric problems in childhood/adolescent compared with trauma in the client's childhood and the client's current psychiatric status.     

Comparison on predictors of mental health service use among Asian older adults

Studies have mostly examined mental health service use of older Asian immigrant combining all Asian Americans into one group whereas immigration backgrounds and socioeconomic status of each Asian minority group are different. Therefore, this study aimed to identify predictors of mental health service use within specific ethnic groups among older Asian adults focusing on Chinese, Japanese, Korean, Filipino, and Vietnamese in California. The Behavioral Model for Vulnerable Populations (BMVP) is used to guide the secondary data analysis of a sample of 3,453 older Asian immigrants from the California Health Interview Survey (CHIS). Logistic and linear regression analyses are performed to examine predictors of mental health service use and the frequency of mental health service use, respectively. As results, mental health‐seeking patterns differ by ethnicity within the older Asian immigrant sample, not being married (Korean), higher levels of acculturation (Filipino), lower levels of neighborhood cohesion (Korean and Vietnamese), higher levels of perceived safety (Korean) and lower levels of perceived safety (Vietnamese), higher levels of mental distress (Korean and Filipino), and having perceived need (all) were related to more visits for mental health services. The study findings highlight the necessity of cultural competency services and programs for each Asian ethnicity.     

More than therapy: The link between adverse childhood experiences,social support,and therapeutic services

Adverse childhood experiences (ACEs) have a cumulative effect on physical, emotional, and social well‐being throughout the life course. ACEs also impact parenting practices, which may contribute to intergenerational cycles of trauma. Access to child mental health services and caregiver social support are two protective factors that may reduce the burden of ACEs. To advance understanding of the relationships between caregiver social support and child mental health services among caregivers with ACEs, we interviewed 13 caregivers of young children receiving outpatient mental health services. Thematic analysis revealed the integral role of therapeutic providers in the social support circles of caregivers with high ACE scores. Caregivers frequently named therapeutic providers as the first point of contact in a problem situation. Implications for social work research, clinical practice, and advocacy are discussed.     

Psychosocial Interventions for Maltreated and Violence-Exposed Children

Child sexual, physical, and emotional abuse as well as child neglect and domestic violence, community violence, and Childhood Traumatic Grief may result in significant and long-lasting emotional and behavioral difficulties. This article reviews randomized controlled studies that have assessed child mental health outcomes for maltreated and violence-exposed children. Key points of this review include the following: (1) maltreated and violence-exposed children typically experience more than one of these types of traumas; (2) effective psychosocial treatments are available to address Posttraumatic Stress Disorder (PTSD), depression, anxiety, and behavioral problems in these children; (3) it is likely that treatments which effectively reduce mental health symptoms in children exposed to one type of child maltreatment or violence exposure will also be effective for other or multiple types; and (4) mental health outcomes are not the only important outcomes to address in future treatment or intervention efforts. These future directions for treatment intervention research are addressed.     

The effects on children of witnessing violence: implications for social work practice

The study adopted a retrospective design to understand the effects of witnessing intimate partner violence (IPV) on children during their childhood and later in their adult life. The study was based on in-depth interviews with 12 adults from Hong Kong who had witnessed violence in their childhood. The respondents were chosen using an available sampling method. Thematic content analysis was used for data analysis. The findings of this study suggest that long-term adverse effects of witnessing violence are not caused simply by exposure to IPV in childhood, but the effects are associated with the social construction of victim identity.     

Phenotypic Bias and Ethnic Identity in Filipino Americans*

Objective. Links between phenotypes (skin tone, physical features) and a range of outcomes (income, physical health, psychological distress) were examined. Ethnic identity was examined as a protective moderator of phenotypic bias. Method. Data were from a community sample of 2,092 Filipino adults in San Francisco and Honolulu. Results. After controlling for age, nativity, marital status, and education, darker skin was associated with lower income and lower physical health for females and males. For females, more ethnic features were associated with lower income. For males, darker skin was related to lower psychological distress. One interaction was found such that females with more ethnic features exhibited lower distress; however, ethnic identity moderated distress levels of those with less ethnic features. Conclusions. Phenotypic bias appears prevalent in Filipino Americans though specific effects vary by gender and skin color versus physical features. Discussion centers on the social importance of appearance and potential strengths gained from ethnic identification.     

Korean Survivors of the Japanese “Comfort Women” System: Understanding the Lifelong Consequences of Early Life Trauma

Prior to and during World War II, thousands of girls and young women were abducted from Korea and forced into sexual slavery by the Japanese government. Termed comfort women, these girls and young women suffered extreme sexual, physical, and emotional abuse and trauma. Research on this group is not well-developed and people know little of the impact of this early life trauma on the lives of these women who are now in later life. Using snowball sampling, 16 older adult survivors of the comfort women system participated in semistructured qualitative interviews. Thematic analysis was conducted to gain an understanding of the trauma that these women suffered and how it impacted their lives. Results revealed the depths of the abuse these women suffered, including repeated rapes, physical beatings, humiliation, forced surgery and sterilization, and social exclusion. These early traumatic experiences appeared to reverberate throughout their lives in their family relations, their inability to marry and to conceive children, and their emotional and physical well-being throughout the life course and into later life. The experiences of these survivors illustrate the lasting impact of early-life trauma and can guide interventions with current survivors of sexual abuse or trafficking.     

The relationship between perceived parental physical availability and child sexual,physical and emotional abuse among high school students in the Northern Province,South Africa

This is an investigation into the relationship between perceived parental physical availability and child sexual, physical and emotional abuse among high school students in the Northern Province (South Africa). All the secondary school students in standards 9 and 10 in three secondary schools filled in a retrospective self-rating questionnaire in a classroom setting. The questionnaire asked questions about perceived parental physical availability during childhood, and childhood sexual, physical and emotional abuse. Logistic Regression Analysis shows that among all the participants, “haven ever had a stepfather or adoptive father until he or she was at least 16 years old” and again, “haven ever had a stepfather or adoptive father until he or she was at least 16 years old” and “haven lived in a ‘group home’ until he or she was at least 16 years”; and “haven been raised by any other adult” predict child sexual, physical and emotional abuse, respectively. Mental health and social workers, educators and law enforcement agencies dealing with prevention and protection against child abuse in the Province should take note of the above identified predictors while designing programmes for the eradication of child sexual, physical and emotional abuse.