Dyadic Influence of Adverse Childhood Experiences: Counseling Implications for Mental and Relational Health

Adverse childhood experiences (ACEs) predict physical and mental health. We examined dyadic differences in intimate partner relationship health by ACE score among couples with low to moderate income enrolled in a relationship education program. Overall, we found a high prevalence of ACEs, disproportionate representation in the highest risk ACE group, and a significant effect between ACEs and indicators of mental and relational health. Implications for counselors include support for an ACE‐informed approach to couples counseling services, as well as a holistic and systemic view of mental and relational health.     

A Qualitative Exploration of Athletes' Past Experiences With Doping Prevention Education

The purpose of this study was to explore athletes' experiences with doping education and their recommendations to improve current education to create more effective doping prevention interventions. Following a constructivist approach, interviews were conducted with 21 athletes and analyzed inductively with thematic analysis. Six themes were identified relating to athletes' experiences with doping education and recommendations for improving it. Athletes commonly described receiving insufficient doping education during adolescence, highlighting the need for increased doping prevention efforts. Recommendations for future educational programs include addressing doping prevention collaboratively, implementing education at younger ages, and assuring the programs are engaging and interactive.     

Adverse Childhood Experiences and Diabetes in Adulthood: Support for a Collaborative Approach to Primary Care

Prior studies have demonstrated an association between retrospective reports of experiencing trauma in childhood and the current incidence of type 2 diabetes in adulthood. Much less is known about this association among low-income minority patients in primary care settings. We replicated the adverse childhood experiences (ACEs) Centers for disease control and prevention (CDC) study with a low-income minority sample of primary care patients (N = 801) at a community-based healthcare center. We conducted a cross-sectional retrospective quantitative survey study to examine the association between participants’ reports of past childhood trauma and their current health care outcomes. Data were analyzed using binary logistic regression to evaluate the hypothesis that low income minority patients who reported more childhood trauma (abuse, neglect, household dysfunction, cumulative adverse childhood experiences [ACEs]) would more likely be diagnosed with type 2 diabetes. Results suggest that the number of ACEs in our sample were considerably higher than the original CDC ACEs study, as almost 50 % of patients surveyed at our clinic reported 4 or more ACEs, confirming that trauma is central in our urban primary care setting. The results of the cumulative ACEs score was in the expected direction and was significant, suggesting that participants who cumulatively reported experiencing more childhood trauma were more likely to be diagnosed with type 2 diabetes in adulthood. These findings have implications for family therapists, primary care providers, researchers, and policy makers to develop more collaborative approaches to primary care that better target the negative sequelae of ACEs.     

A Community's Response to Adverse Childhood Experiences: Building a Resilient,Trauma‐Informed Community

Adverse childhood experiences, or ACEs, may be mitigated by trauma‐informed social environments—programs, services, systems, communities—that offer responses to trauma that promote healing, recovery, and resilience. However, there is currently little empirical evidence to support the use of specific approaches to do so. Guided by a population health perspective, this paper describes a participatory community change process in response to ACEs that seeks to build a resilient, trauma‐informed community in Pottstown, PA. We examine the initial implementation phase of this change process, centered originally on the education sector and the social and behavioral health services sector, and then eventually expanding to 14 community sectors across two years. A variety of data sources and methods are used to track individual and organizational processes, as well as service system network processes. A central feature of this research is the use of data to generate hypotheses rather than test them. Data were also used to guide understanding and decision‐making during implementation. The results show that moving forward the community is well‐positioned to establish stronger inter‐agency and system supports for trauma‐informed practice in the service system and in the broader community. We discuss results for their implications for building resilient, trauma‐informed communities.     

Trainee and Client Experiences of Therapeutic Assessment in a Required Graduate Course: A Qualitative Analysis

Surveys indicate that practice and training in psychological assessment, and personality assessment (PA) to a lesser degree, has been stable or increasing over the past quarter-century. However, its future arguably remains threatened due to changes in doctoral training programs and beliefs in the field concerning the utility of PA for treatment success. To increase interest in and use of PA, studies of training methods that include trainees' perspectives are needed. This study evaluated the experiences of 10 graduate trainees and their clients who were trained in and conducted a brief Therapeutic Assessment (TA). Qualitative responses to a self-evaluation administered post-TA were coded using directed content analysis. Results indicated that trainees viewed TA/PA as having clinical utility; they had positive feelings about TA/PA, and they desired or intended to use or continue learning about TA/PA. Clients' responses reflected positive feelings about the TA, having gained new self-awareness or understanding, and having a positive relationship with the assessor. The findings suggest that teaching PA from a TA perspective could produce positive benefits for psychology trainees.     

Adverse Childhood Experiences: A 20-Year Content Analysis of American Counseling Association and American School Counselor Association Journals

The purpose of this content analysis was to illustrate trends related to the use of the term adverse childhood experiences (ACEs), or terms related to the 10 components of ACEs, within 140 peer-reviewed articles published in 22 journals affiliated with the American Counseling Association (ACA) and the American School Counselor Association (ASCA) between 1998 and 2018. Of the 9,120 articles published in the 22 ACA- and ASCA-affiliated journals in that time, only three articles (0.03%) explicitly mentioned the term adverse childhood experiences in the title, abstract, or keywords. Authors of 93 journal articles mentioned terms related to the original 10 categories of ACEs 104 times (1.0% of all published articles). The need for consistent language across research and practice is highlighted. Implications include ways that the counseling field may benefit from an increased clarity and focus around ACEs.     

Adverse Childhood Experiences,Trauma Symptoms,Mindfulness, and Intimate Partner Violence: Therapeutic Implications for Marginalized Men

Adverse childhood experiences (ACEs) and trauma symptoms have been linked with intimate partner violence (IPV) perpetration and victimization among men, yet the field lacks depth in several key areas hampering progress toward violence intervention. Specifically, posttraumatic stress disorder (PTSD) dominates the field’s scope of trauma symptoms under study, limiting understanding of other manifestations of trauma especially among men. Furthermore, most research focuses exclusively on men’s physical IPV perpetration and rarely focuses on other types of IPV, severity of violence, or men’s victimization. Also, few studies examine potential protective factors grounded in the ACE framework, such as mindfulness, among clinical populations. Finally, most research has not focused on men of color, despite some racial/ethnic minority groups disproportionate rates of IPV exposure. Therefore, the relationships between IPV frequency and severity (psychological, physical, injury) and ACEs, PTSD, trauma symptomology (separate from PTSD), and mindfulness self-efficacy were examined in a sample of 67 predominantly low-income men of color in a batterer intervention program. More than half of the sample (51.5%) reported exposure to four or more ACEs, and 31.1% met the clinical cutoff for a probable PTSD diagnosis. Higher ACE scores predicted increased rates for nearly all types of self-reported IPV perpetration and victimization. PTSD symptoms and complex trauma symptom severity together explained between 13% and 40% of IPV outcomes, and each was uniquely associated with certain types of self-reported IPV victimization and perpetration frequency and severity. Mindfulness self-efficacy was associated with decreased self-report psychological IPV perpetration and victimization frequency and severity. Clinical implications relevant to marginalized men are reviewed, including screening, training, and potential therapeutic interventions.     

A Framework for Valuing Investments in a Nurturing Society: Opportunities for Prevention Research

Investing in strategies that aim to build a more nurturing society offers tremendous opportunities for the field of prevention science. Yet, scientists struggle to consistently take their research beyond effectiveness evaluations and actually value the impact of preventive strategies. Ultimately, it is clear that convincing policymakers to make meaningful investments in children and youth will require estimates of the fiscal impact of such strategies across public service systems. The framework offered here values such investments. First, we review current public spending on children and families. Then, we describe how to quantify and monetize the impact of preventive interventions. This includes a new measurement strategy for assessing multisystem service utilization and a price list for key service provision from public education, social services, criminal justice, health care and tax systems.     

Experiences and Perceived Effects of Rosary Praying: A Qualitative Study

Journal of Religion and Health - The aim of this study is to explore experiences and perceived effects of the Rosary on issues around health and well-being, as well as on spirituality and...     

Mobilizing Communities for Implementing Evidence-Based Youth Violence Prevention Programming: A Commentary

Evidence-based programs have struggled for acceptance in human service settings. Information gleaned from these experiences indicates that implementation is the missing link in the science to service chain. The science and practice of implementation is progressing and can inform approaches to full and effective uses of youth violence prevention programs nationally. Implementation Teams that know (a) innovations, (b) implementation best practices, and (c) improvement cycles are essential to mobilizing support for successful uses of evidence-based programs on a socially significant scale. The next wave of development in implementation science and practice is underway: establishing infrastructures for implementation to make implementation expertise available to communities nationally. Good science, implemented well in practice, can benefit all human services, including youth violence prevention.     

Relationship Distress as a Mediator of Adverse Childhood Experiences and Health: Implications for Clinical Practice with Economically Vulnerable Racial and Ethnic Minorities

Adverse childhood experiences (ACE) are interpersonal sources of distress negatively correlated with physical and mental health, as well as maladaptive intimate partner conflict strategies in adulthood. Economically vulnerable racial and ethnic minorities report the greatest disparities in exposure to ACE, as well as relationship distress and health. Yet, little is known about the connections between ACE, relationship distress, and health. We therefore tested a theoretical model for the mediating role of relationship distress to explain the ACE‐health connection with a sample (N = 96) predominantly racial/ethnic minorities (87%) with low income. We applied partial least squares structural equation modeling with bootstrapping (N = 500). Relationship distress strengthened the predictive relationship between ACE and health, and accounted for 42% of the variance in health. The results provide preliminary support for relationship distress as a social determinant of health disparities with implications for interdisciplinary health intervention.     

Co-Occurring Youth Profiles of Adverse Childhood Experiences and Protective Factors: Associations with Health,Resilience, and Racial Disparities

It is important to understand racial/ethnic differences in adverse childhood experiences (ACEs), given their relationship to long-term physical and mental health, and the public health cost of the significant disparities that exist. Moreover, in order to inform interventions and promote resilience, it is critical to examine protective factors that mitigate the relationship between adversity and poor health. The current study utilized latent transition analyses (LTA) to examine co-occurring profiles of ACEs and protective factors (from school, family, and community contexts) and links to health outcomes among 30,668 Black (10.4%), Latinx (12.3%), and White youth (77.3%) ages 12–17 (52.5% male) who participated in the 2011–12 National Survey of Children's Health (NSCH). Results suggested that greater adversity was associated with worse health, while more access to protective factors was associated with better health. White youth had consistently lower endorsement of ACEs, greater access to protective factors, and better health compared to their Black and Latinx counterparts. Efforts to improve child health and racial/ethnic disparities in research and practice must consider adversity, protective factors, and the systemic inequities faced by racial/ethnic minority youth in the United States.     

Shared Communities: A Multinational Qualitative Study of Immigrant and Receiving Community Members

Community psychology is central to understanding how immigrants and more established residents of their new settings join together to develop a shared sense of community and membership. In our present study, we explored how newer (i.e., first‐ and second‐generation immigrants) and more established community members form multiple positive psychological sense of community (PSOC) with one another. We conducted a multinational, qualitative study of PSOC through interviews with 201 first‐ and second‐generation immigrants and third generation or more “receiving community members” in three contexts (Baltimore‐Washington corridor of the U.S.; Torino, Italy; Lecce, Italy). Results indicated numerous similarities among the ways in which participants constructed PSOC in shared and nonshared communities, regardless of immigration/citizenship status, length of community residence, city, country, age, or gender. Small, proximal, and salient communities were often particularly important to building positive PSOC, which was formed around diverse membership boundaries. As intersectional beings, members converged and diverged on many characteristics, providing multiple opportunities for members to bring diversity to their communities while sharing other characteristics deemed essential to membership. Nonetheless, findings point to significant, structural challenges rooted in power and privilege that must be confronted to bridge the community‐diversity dialectic and build strong, shared sense of community.     

Relapse Prevention Techniques in the Treatment of Childhood Anxiety Disorders: A Case Example

Research has shown that cognitive behavioral therapy (CBT) is an efficacious treatment for children and adolescents with anxiety disorders. CBT incorporates techniques such as cognitive restructuring and exposure, which foster symptom reduction. While these components promote sustained fear reduction, greater attention to relapse prevention (RP) may be warranted, particularly given the comorbidity associated with anxiety disorders. A case example demonstrates a comprehensive relapse prevention (RP) component. Specifically, parental involvement was emphasized as well as the creation of a bound book that consolidated skills and provided a concrete resource for potential future anxious episodes.     

Influence Opportunities and the Development of Argumentation Competencies in Childhood

Whether argumentation competencies are associated with the kind of influence opportunities children have in their lives is the focus of this study. The hypothesis is that when children have the opportunity to initiate and evaluate arguments, hear others make and examine arguments, and participate equally in resolving disputes, children are able to develop their argument skills. Four argumentation competencies associated with critical discussions of proposals are identified: creating consensus about problematic situations, advocating proposals, facilitating behavioral commitment, and integrating identities. Second, fourth, and sixth grade children completed tasks that assessed their influence opportunities and argument competencies. Children who perceived themselves to have many collaborative influence opportunities, that is, opportunities in which they could engage in mutual influence, had more highly developed argument competencies than children who did not have such opportunities. As predicted, this relationship occurred with the argument competencies of problem conception, proposal advocacy and facilitating commitment. Measures of non-collaborative influence opportunities were not associated with argument competencies. Together, the results suggest that discussions in which children are given the opportunity to influence and be influenced with arguments may provide the best context for children to develop their argument skills.