Childhood Adversity Phenotypes and Risky Health Behaviors among Chinese Adolescents: Extending the Concept of Adversity

ObjectiveTo present an approach to phenotyping ACEs and explore the association between ACEs and adolescent health risky behaviors based on the social context of China.Methods Totally,5,726 adolescents aged 12-18 years were investigated about their ACEs in the family,peer,school,and personal domains and the occurrence of six types of risky health behaviors(i.e.,smoking,drinking,sexual intercourse,self-harm,and suicidal ideation and attempts).Latent class analysis(LCA)was used to explore the ACE patterns.Results Six latent classes of ACEs were identified,including low adversity,school adversity,school adversity and peer victimization,peer victimization,maltreatment and peer victimization,and high adversity,and associated with risky health behaviors in adolescents.Being physically punished by a teacher,experiencing sexual abuse,and experiencing family trauma most strongly differentiated from the six AcE classes and were correlated with an increased risk for risky adolescent health behaviors.ConclusionThis study supports a positive association between ACEs and risky adolescent health behaviors.Peer victimization,school adversity and associated contexts need to be considered in future ACEstudies.

Associations between Mental Health Outcomes and Adverse Childhood Experiences and Character Strengths among University Students in Southern China

Adverse childhood experiences(ACEs)can negatively affect mental health,whereas character strengths seem to be positively correlated with mental health.Detailed information on the history of ACEs among university students in China and the extent which mental health is associated with ACEs and character strengths can contribute to the needed empirical evidence for relevant stakeholders.Objectives of this study are 1)to estimate the prevalence of ACEs among undergraduate students in Southern China;and 2)to assess the extent which mental health outcomes(positive growth,well-being,and depression)are associated with ACEs and character strengths among undergraduate students in Southern China.We conducted a self-administered survey amongfirst and second-year students at a university in Southern China and analyzed data using descriptive statistics and linear regression analyses.Among the 779 students who completed the questionnaire,283 were males,439 were females,and 57 did not indicate their gender.The prevalence of ACEs among the participants was 32.1%.History of ACEs was associated with lower positive growth score(Adjusted Beta=-0.20;95%CI=-0.37,-0.02;p=0.030)and lower well-being score(Adjusted Beta=-1.13;95%CI=-2.04,-0.23;p=0.014).Vitality domain of character strength was associated with all three mental health outcomes after adjusting for covariables(all p-values<0.001).Our studyfindings provide empirical evidence for stakeholders in university mental health.However,caveats regarding lack of temporality,selection bias,social desirability bias,and lack of generalizability should be considered in the interpretation of the studyfindings.

Peptic ulcer and childhood adversities experienced by working-aged people

AIM: To study the association between self-reported peptic ulcer and childhood adversities.METHODS: The Health and Social Support Study (HeS-Sup) population consisted of a stratif ied random sample drawn from the Finnish Population Register in four age groups: 20-24, 30-34, 40-44 and 50-54. The survey was carried out by postal questionnaire during 1998, with a response rate of 40.0%. A follow-up questionnaire was sent during 2003 to all those who responded to the f irst. Altogether 19 626 individuals returned the follow-up questionnaire; a response rate of 75.8%. The subjects were asked whether a doctor had told them that they have or have had peptic ulcer. The analyses covered those who responded aff irmatively to both the baseline and the follow-up enquiries (n = 718). Those not re-porting a peptic ulcer in either of the two questionnaires (n = 17 677) were taken as controls. The subjects were further requested (through six questions) to think about their childhood adversities.RESULTS: The most common adversities mentioned were long-lasting financial difficulties in the family, serious conflicts in the family, and a family member seriously or chronically ill. All the adversities reported, except parental divorce, were more common among peptic ulcer patients than among controls (P values varied between < 0.001 and 0.003). Age- and sex-adjusted odds ratios (OR) of childhood adversities in the multivariate logistic analysis for self-reported pep-tic ulcer varied between 1.45 and 2.01. Adjusting for smoking, heavy drinking, stress and nonsteroidal anti-inflammatory drug use had no further influence (ORs between 1.22 and 1.73).CONCLUSION: Our findings suggest that childhood adversities maintain a connection with and have a predictive role in the development of peptic ulcer.

Childhood trauma: the cause that needs a cure

Children from all walks of life are subjected to traumatic experiences.Having one traumatic experience,while unfortunate,generally does not have much impact on the child’s future,as one might expect.This review examines the long-term psychoneuroendocrinologocal implications of repeated or prolonged exposure to traumatic events during childhood,particularly during the formative years which include chronic illnesses,terminal illnesses,psychological disorders,neurological disorders,and more which has resulted in an average reduced life expectancy of 20-years.Proposed modifications for screening tools,prevention,and interventions are explained and introduced.In conclusion,this review proposes a modified and universal approach to screening,prevention,and treatment for those at high risk and those already afflicted by childhood trauma based on the latest in evidence-based research.

Relationships between Fetal Alcohol Spectrum Disorder, Adverse Childhood Experiences, and Neurodevelopmental Diagnoses

Objective: Children with fetal alcohol spectrum disorder (FASD) are overrepresented in early intervention programs, foster care, special education, juvenile corrections, and mental health services. In this study, we examine relationships between FASD and non-FASD controls for adverse childhood experiences (ACEs), and neurodevelopmental disorders. Methods: A chart review was conducted among patients seen at our clinic from 2010-2017 with data on FASD, ACEs, neurodevelopmental diagnoses, and foster or residential care placement available. Results: Relative risk for FASD was increased in patients with increased ACE scores (RR = 5.08), increased numbers of neurodevelopmental diagnoses (RR = 2.36), and patients who have been in foster or residential care (RR = 9.53). FASD risk increased as ACE scores or the number of neurodevelopmental diagnoses increased. Patients with any ACEs were 3.96 times more likely to have FASD, and those with eight or more ACEs were 6.31 times more likely to have FASD than those with no ACEs. Patients with three or more neurodevelopmental diagnoses were 6.55 times more likely to have FASD than those with two or fewer diagnoses. Nine or more diagnoses increased the risk for FASD ten-fold (RR = 10.91). Conversely, patients diagnosed with FASD were more likely to have at least three ACEs (RR = 3.71), at least five neurodevelopmental diagnoses (RR = 1.61), and high rates of previous foster or residential care placement (RR = 5.39). Conclusion: This study demonstrates that all children being considered for placement in foster care or residential should be screened for FASD.

Childhood Adversities Associated with Eating Disorders Reported by Adults

Background: It has been suggested that childhood events increase the risk of suffering from an eating disorder (ED) in adolescence or young adulthood. Our study here aimed at investigating whether there was an association between stressful childhood events and eating disorders later in life. Methods: Our population-based study was a part of the HeSSup (The Health and Social Support) postal survey in 2003, a follow-up survey with a random sample of working-aged subjects drawn from the Finnish Population Register in 1998. Participants in this study reported having been suffering from ED (N = 374), while controls (N = 18,639) reported no history of eating disorder in the questionnaire both in 1998 and 2003. The questionnaire included six questions related to childhood adversities. Results: Each childhood stressor increased the risk of developing ED cumulatively (one adversity OR 1.7 versus all six OR 8.3). Intrafamiliar conflicts (OR 2.0), being afraid of a family member (OR 1.5) or long-term illnesses in the family (OR 1.4) increased the ED-risk statistical significantly. Conclusion: Children exposed to stress are more likely to suffer from eating disorders as adults than those not exposed.

Importance of methodological considerations in documenting psychological trauma

The documentation of psychological trauma is obviously a challenge to clinicians while they are diving deep into remote events related to their clients or patients.The potential role of psychological trauma in the early developmental stages,and even the existence of adverse childhood experiences,is important to prove,yet it is difficult to do so.A diverse range of methods have been applied,all of which presumably benchmark a big therapeutic step;however,these enthusiastic methods frequently do not last for long.While hypnosis supporters,Freudian and Neo-Freudian disciples can be acute enough to enhance and uncover suppressed memories,modern psychiatry relies mostly on diversely structured interviews.Functional magnetic resonance and its related subtleties might help,but the questions that remain unanswered are numerous and confusing.Connecting early experiences with long-term memory while identifying psychological trauma its importance for the individual’s growth trajectory;thus,it remains an intriguing issue.

The Scientific Evidence That Today’s Psychiatry Cripples Itself—By Excluding‘Intent’

PSYCHIATRISTS DISAGREE profoundly with lawyers,about what we human beings are capable of.The one says we have‘intent’—the other that we do not.They cannot both be right.All non-psychiatrist doctors must perforce agree with the lawyers.This paper argues that these harmful discrepancies will continue,until we undo the separate watertight human knowledge silos,which have grown up between legal procedures,general medicine,and psychiatric practice.All three would benefit.Psychiatry in particular,suffers from a grievously narrow view of scientific evidence,one which is open to fundamental criticism.There are radical differences in how the fuzzy concept of‘intent’is regarded in law,in general clinical medicine and in psychiatry.Once‘intent’is accorded its due weight,our understanding of justice,health and sanity is vastly improved,allowing us hugely more optimism.This paper is based on two earlier papers—The Scientific Evidence That‘Intent’Is Vital for Healthcare and Why Quakerism Is More Scientific Than Einstein.These are deployed here,to unpick the unhealthy tangle in which today’s psychiatry now finds itself.Its six sections are—(1)why‘intent’matters in law,in medicine&in psychiatry;(2)scientific quagmires;(3)a working definition for‘madness’;(4)“children are impressionable”;(5)“trust me,I’m a doctor”;and(6)skin heals,why can’t minds?The breakthrough is that verbal fuzziness means that words can mean different things at different times––not that they are 100%meaningless.Only a better understanding of trust,autonomy and consent can open the way to something that is painfully absent from today’s psychiatry––a cure for any and all mental disease.

The Myth of Attention-Seeking Behavior: Supporting Health and Wellness in People with Autism Spectrum Disorders and Intellectual Disabilities

As a behavioural consultant, one of the most common phrases used in referral information is that the individual is engaging in a series of behaviors “just to get attention”. Attention has been postulated as a motivation for behavior by the most widely used behavioral assessments such as the Motivation Assessment Scale, the Functional Assessment Screening Tool and others. This article will present the concept that people do not want attention, rather they want the things attention brings, such as safety, affection, acceptance and other needs. In a sense, attention is the means to an end, and not the end itself. A conceptualization for identifying the reinforcers sought by people using behavior to get the attention of others is presented within the context of a single case study.

Gene×environment interaction in major depressive disorder

Major depressive disorder(MDD)is a multifactorial disorder,where multiple susceptibility genes interact with environmental factors,predisposing individuals to the development of the illness.In this article,we reviewed different gene×environment interaction(G×E)studies shifting from a candidate gene to a genome-wide approach.Among environmental factors,childhood adversities and stressful life events have been suggested to exert crucial impacts on MDD.Importantly,the diathesis-stress conceptualization of G×E has been challenged by the differential susceptibility theory.Finally,we summarized several limitations of G×E studies and suggested how future G×E studies might reveal complex interactions between genes and environments in MDD.