The Relationship of Adverse Childhood Experiences to PTSD,Depression, Poly-Drug Use and Suicide Attempt in Reservation-Based Native American Adolescents and Young Adults

Adverse childhood experiences (ACEs) are associated with numerous risk behaviors and mental health outcomes among youth. This study examines the relationship between the number of types of exposures to ACEs and risk behaviors and mental health outcomes among reservation‐based Native Americans. In 2011, data were collected from Native American (N = 288; 15–24 years of age) tribal members from a remote plains reservation using an anonymous web‐based questionnaire. We analyzed the relationship between six ACEs, emotional, physical, and sexual abuse, physical and emotional neglect, witness to intimate partner violence, for those <18 years, and included historical loss associated symptoms, and perceived discrimination for those <19 years; and four risk behavior/mental health outcomes: post‐traumatic stress disorder (PTSD) symptoms, depression symptoms, poly‐drug use, and suicide attempt. Seventy‐eight percent of the sample reported at least one ACE and 40 % reported at least two. The cumulative impact of the ACEs were significant (p < .001) for the four outcomes with each additional ACE increasing the odds of suicide attempt (37 %), poly‐drug use (51 %), PTSD symptoms (55 %), and depression symptoms (57 %). To address these findings culturally appropriate childhood and adolescent interventions for reservation‐based populations must be developed, tested and evaluated longitudinally.     

Mediation of Childhood Adversity and Health by Relationship Quality in Diverse Couples

Individuals with economic disadvantage experience greater (a) adverse childhood experiences (ACE), (b) risk for low relationship quality and relationship dissolution, and (c) disparity in physical and mental health. Thus, a critical need exists to understand the connections between areas of disparity in family and relational health on physical and mental health for those most vulnerable to the deleterious effects. The researchers therefore tested a dyadic model for the mediation of ACE and health by relationship quality with data from 503 couples with economic disadvantage and a racial or ethnic minority background (76.9%). The data fit the proposed model and explained a majority of the variance in health, 82.3% of the variance in menʼs health and 56.5% in womenʼs health—both large effects. Moreover, the significant indirect pathway between ACE and health through relationship quality contributed 98.05% and 57.40% of the total effects for men and women, respectively. Overall, a significant relationship existed between ACE, relationship quality, and health for men and women at the actor-level and the dyadic influence between members of a couple contributed to the overall model fit. Results add to support for the role of relationship quality as a dyadic social determinant of health disparities with implications for prevention and intervention.     

Impact of maternal adverse childhood experiences on child socioemotional function in rural Kenya: Mediating role of maternal mental health

Mothers in low‐ and middle‐income countries (LMIC) suffer heightened vulnerability for adverse childhood experiences (ACEs), which is exacerbated by the multitude of risk factors associated with poverty and may lead to increased risk of psychiatric disorder. The constellation of complex, co‐occurring biological, environmental, social, economic and psychological risk factors are in turn transmitted to her child, conferring vulnerability for adverse development. This study examines the association between maternal intra‐ and extra‐familial ACEs, maternal education and the mental health of her child, mediated by maternal mental health. Mother‐child dyads (n = 121) in Machakos, Kenya were examined cross‐sectionally using self‐report measures of ACEs, maternal mental health and child internalizing and externalizing mental health problems. The four models proposed to examine the relationship between intra‐ and extra‐familial maternal ACEs and child internalizing and externalizing problems demonstrated indirect pathways through maternal mental health. These effects were found to be conditional on levels of maternal education, which served as a protective factor at lower levels of maternal ACEs. These models demonstrate how the impact of ACEs persists across the lifespan resulting in a negative impact on maternal mental health and conferring further risk to subsequent generations. Elucidating the association between ACEs and subsequent intergenerational sequelae, especially in LMIC where risk is heightened, may improve targeted caregiver mental health programs for prevention and intervention.     

The association between adverse childhood experiences and personality,emotions and affect: Does number and type of experiences matter?

BackgroundThere is strong evidence that adverse childhood experiences (ACEs) negatively impact mental health. However, the association between ACEs and personality, emotions and affect are poorly understood. Therefore, we examined the association between composite ACE score and ACE type and personality, emotions and positive and negative affect.MethodsThree waves of data from the Midlife Development in the United States (MIDUS) study were used. ACE was the primary independent correlate. Covariates included demographic variables and survey wave. Outcome variables included generativity, personality traits (agreeableness, conscientiousness, extraversion, neuroticism, openness, agency), and affect (positive, negative). Statistical analyses included 3 approaches: (1) treatment of ACE as dichotomous, (2) ordinal composite of ACE score, and (3) three individual ACE type components to assess the association between ACE and psychological constructs.ResultsOf 6323 adults in the sample, 53% were female, and 56% had a past ACE. In the adjusted analyses, dichotomized ACE was significantly associated with neuroticism (β = 0.10; 95% CI 0.07, 0.13) and conscientiousness (β = −0.03; 95% CI −0.05, −0.01). All ACE scores were significantly and positively associated with neuroticism and negatively associated with conscientiousness. Abuse was significantly associated with neuroticism (β = 0.20; 95% CI 0.16, 0.24), openness (β = 0.08; 95% CI 0.05, 0.11), conscientiousness (β = −0.05; 95% CI −0.08, −0.02), and agency (β = 0.06; 95% CI 0.02, 0.10). All ACE categories, except financial strain, were significantly associated with affect.ConclusionACEs are significantly associated with personality, emotions, and affect, with greater effect seen at higher ACE scores and with ACE abuse type, which helps support the cumulative risk hypothesis and our study hypothesis. There is a need for continued research to understand the mechanistic processes and the directionality of the association between ACEs, emotions, and behaviors to help continue to drive biopsychosocial interventions.     

Adverse childhood experiences,religious/spiritual struggles,and mental health symptoms: examination of mediation models

Emerging research has documented greater risk for posttraumatic stress disorder (PTSD) and depression among young adults with prior adverse childhood experiences (ACEs). Building upon prior findings, we hypothesised that religious/spiritual (R/S) struggles may serve as an intervening pathway through which accumulation of ACEs impacts mental health symptom severity in this population. Young adults (N?=?458) were recruited from a southeastern university to complete an online self-report survey that assessed for ACEs, lifetime trauma exposure, R/S struggles, PTSD and depressive symptomatology. Bivariate correlations yielded significant positive relationships between ACEs and all six types of R/S struggles, depression, and PTSD. Additionally, when accounting for non-childhood trauma exposure, the mediational analyses indicated an indirect effect of struggles with ultimate meaning on the well-establish association between ACEs and mental health symptoms. Clinical implications (such as the importance of fostering meaning making), study limitations, and future research directions are discussed.     

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.     

Do Parents’ Adverse Childhood Experiences Influence Treatment Responses to Parent-Child Interaction Therapy? An exploratory Study with a Child Welfare Sample

This exploratory study of 23 parent–child dyads receiving child welfare services examined the association between the number of adverse childhood experiences (ACEs) parents reported and their children’s externalizing behaviors. We also assessed whether the effects of Parent-Child Interaction Therapy (PCIT) on externalizing behaviors varied by parents’ ACE histories. Results indicated that parents’ ACE scores were associated with child externalizing symptoms at baseline, but not at a second postbaseline assessment. Although all parents reported reductions in child externalizing behavior from baseline to postbaseline, only reductions reported by parents with four or more ACEs were statistically significant. Implications for implementing PCIT with trauma-exposed families are discussed.     

Coparental communication,relational satisfaction,and mental health in stepfamilies

This study tested a series of actor–partner interdependence models of coparental communication, relational satisfaction, and mental health in stepfamilies. Participants included 127 couples (N = 254). Results revealed 2 actor‐oriented models whereby parents' and stepparents' coparental communication quality positively predicted their own (but not their partners') satisfaction and mental health. A final model revealed that parents' relational satisfaction mediated the effect of coparental communication on their own mental health. A similar pattern emerged for stepparents, although coparental communication continued to have a direct, positive effect on stepparents' mental health. Importantly, parents' coparental communication produced an inverse partner effect on stepparents' mental health, highlighting the potential stress stepparents may experience as they are called upon to help raise their spouse's offspring.     

Mental Health Utilization Among Diverse Parenting Young Couples

Mental health issues often become apparent as adolescents emerge into young adulthood. The use of mental health services is low among adolescents and young adults, and use is particularly low among minorities. In this study, we examine mental health utilization among diverse young parenting couples. The sample consisted of 296 couples. We used the social–personal framework to examine personal, family, partner relationship, and environmental predictors for using mental health services. We used the Actor–Partner Interdependence Model to assess actor and partner effects on mental health utilization. We also examined moderator effects for gender and internalizing and externalizing behaviors. We found that being female, being White, higher income, more conduct problems, and less anxious romantic attachment predicted mental health utilization. Significant moderator effects included depression × gender, depression × medical insurance, and stress × Latino. Implications for community mental health practice include conducting mental health assessments during medical visits and systematic mental health follow‐up for individuals and couples with identified mental health and support needs. Future research should include married couples and the spouse’s influence on mental health use and examine relevant parenting factors that may also predict mental health utilization among couples.     

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.     

Save the young--the elderly have lived their lives: ageism in marriage and family therapy

The paucity of literature addressing mental health issues concerning geriatric populations represents the perpetuation of ageist practices and beliefs in the field of marriage and family therapy. The purpose of this study was to assess whether client age and clinical training relate to the evaluation of couples who present for conjoint therapy. Written vignettes describing two couples, one older and one younger, who report issues involving the absence of sexual intimacy, increased frequency of arguments, and increased use of alcohol were evaluated by practicing marriage and family therapists, therapists-in-training, and individuals with no clinical background. It was hypothesized that respondents' views would vary in connection with the age of the couple and with the three levels of participant training. Results indicate that client age and participant training are associated with perceptions of individual and couple functioning. Our findings suggest that the relational and mental health concerns experienced by elder couples are not perceived as seriously as are identical concerns experienced by younger couples. Contrary to our expectations the observed differences between views of the two age conditions did not significantly differ between levels of participant training. Training and experience in marriage and family therapy may not significantly mitigate vulnerability to age-discrepant views.     

Pastoral counselling: an American perspective

While pastoral counselling is a function of pastoral ministry in religious communities, it is also a specialised ministry requiring professional training that extends well beyond a pastoral/ theological education for ministry, as well as beyond the confines of religious communities. This article is an American perspective on Certified Pastoral Counsellors as mental health care providers for individuals, couples, and families, generally on a fee-for-service basis, with many qualifying for reimbursement by private and federal third party payers. It demonstrates that pastoral counselling as practised in the USA is spiritually integrated counselling and psychotherapy, requiring graduate academic and clinical work in these disciplines as well as graduate education in religious studies. It offers an American perspective on this specialised ministry of mental and relational health and discusses its identity and function, methodology, supervision requirements, and the clinical use of religious resources, including a case illustration.     

Actor–partner interdependence of humility and relationship quality among couples transitioning to parenthood

The transition to parenthood is a challenging experience that often strains relationships, but perceiving one’s partner as humble (actor relational humility) and being perceived by one’s partner as humble (partner relational humility) were hypothesized to benefit couples during this transition. Married couples (N = 69) were tracked from the third trimester of pregnancy through 21 months postpartum. Husbands and wives provided ratings of relational humility and dyadic adjustment. Actor–partner interdependence models tested actor and partner effects of relational humility on dyadic adjustment across the transition. Although couples declined in dyadic adjustment over the transition at the same rate regardless of relational humility (counter to Hypothesis 2), those higher in relational humility reported greater dyadic adjustment at each time point during the transition (consistent with Hypothesis 1). These findings support the benefits of relational humility to relationship quality, and we call for further research into humility’s benefits during times of relationship transition.     

Attitude similarity and familiarity and their links to mental health: An examination of potential interpersonal mediators

Similarity and familiarity with partner’s attitudes are linked to positive relationship outcomes, while interpersonal variables have been linked to mental health. Using multilevel models (MLMs), we modeled the associations between these attitudinal variables and mental health outcomes in 74 married couples. We found that higher levels of attitude similarity in couples were linked to lower depression, while higher levels of attitude familiarity in couples were associated with greater satisfaction with life. Mediational analyses indicated marital satisfaction and interpersonal stress mediated the link between attitude similarity and depression. Marital satisfaction also mediated the link between familiarity and satisfaction with life. This study is the first linking attitude familiarity to mental health and provides evidence that familiarity and similarity have mental health effects partly due to their interpersonal consequences.     

浪漫关系中的关系攻击

浪漫关系中的关系攻击指通过操纵或损害关系以达到伤害浪漫关系伴侣的行为, 可以分为直接攻击和间接攻击,主动性攻击和反应性攻击等类型.浪漫关系中的关系攻击以浪漫关系为攻击目标, 具有冲突解决策略的性质, 在浪漫关系中往往具有相互性.研究者通常使用问卷法对浪漫关系中的关系攻击进行测量.浪漫关系中的关系攻击能够导致较低的关系质量和心理健康水平, 并会引发身体攻击和亲密伴侣暴力.性别,依恋,浪漫关系中的权力和同伴关系中的关系攻击能够对浪漫关系中的关系攻击产生影响.在未来研究中, 应关注浪漫关系中关系攻击的动机, 澄清关系攻击发起与受害之间的关系, 并加强理论建构与干预研究.     

The complementarity of humility hypothesis: Individual,relational, and physiological effects of mutually humble partners

Abstract

We report two studies of romantic couples that examine the interactive effects of actor and partner humility on individual, relational, and physiological well-being. Using both longitudinal (Study 1) and physiological (Study 2) methods from two samples of romantic couples, we explored the interactive effects of actor and partner humility. Individuals in dyads with complementary high humility reported better mental health over time following a major life transition, the birth of their first child, in Study 1 and higher relationship satisfaction and lower physiological responses (i.e. blood pressure) following the discussion of a topic of disagreement in Study 2. These results suggest that being humble is beneficial when one has a humble partner, but being arrogant – especially within a disagreement with one’s partner – could undermine the benefits of humility. That is, the benefits of humility are greatest in dyads in which both partners are humble.     

The Effects of a Couples‐Based Health Behavior Intervention During Pregnancy on Latino Couples’ Dyadic Satisfaction Postpartum

Many couples tend to report steadily decreasing relationship quality following the birth of a child. However, little is known about the postpartum period for Latino couples, a rapidly growing ethnic group who are notably underserved by mental and physical health caregivers in the United States. Thus, this study investigated whether a brief couples’ intervention focused on helping couples support each other while increasing healthy behaviors might improve dyadic functioning postpartum. This study presents secondary analyses of data regarding couple functioning from a larger randomized controlled trial with 348 Latino couples to promote smoking cessation. Portions of the intervention taught the couple communication and problem‐solving skills to increase healthy behavior. Couples participated in four face‐to‐face assessments across 1 year starting at the end of the first trimester. Latent growth curve analyses revealed that the treatment group reported an increase in relationship satisfaction and constructive communication after the intervention, which diminished by 1‐year follow‐up, returning couples to their baseline levels of satisfaction. Results suggest that incorporating a brief couple intervention as part of a larger health intervention for Latinos may prevent postpartum decreases in relationship satisfaction.     

Prevalence and predictors of benevolent childhood experiences among a representative sample of young people

Emerging research evidence suggests that benevolent childhood experiences (BCEs) may partly explain more favourable mental health outcomes among individuals affected by adverse childhood experiences (ACEs). However, much of this research has focused on adult populations. Consequently, this study sought to provide the first rigorous assessment of the prevalence and predictors of BCEs using a nationally representative sample of young people from Northern Ireland (NI). Participants were 11–19-years-olds (N = 1293) who participated in the NI Youth Wellbeing Prevalence Survey (NI-YWS, 2020). Prevalence rates, gender differences and predictors of BCEs were investigated. Results revealed how most of the sample experienced multiple BCEs (95%, n = 1084), with females reporting higher levels of BCEs. Significant positive predictors of BCEs were female gender, parental education, living with both biological parents, and living in areas with lower deprivation, while significant negative predictors of BCEs included family being in receipt of social welfare and older age. Overall, this study highlights how BCEs are common, while the identification of factors associated with likelihood of having positive experiences during early development provides novel insights into those young people who may be at greater risk for maladaptive psychological outcomes.     

Neighborhood Collective Efficacy Moderates the Association between Maternal Adverse Childhood Experiences and Marital Conflict

In a socio‐demographically diverse sample of 501 caregivers participating in a longitudinal birth cohort study during the childbearing years, we examined whether neighborhood collective efficacy moderated the association between maternal adverse childhood experience (ACEs) and marital conflict. Maternal ACEs were assessed via retrospective reports. Neighborhood collective efficacy was measured via maternal and paternal reports at 2 months, and maternal reports of marital conflict were collected at infant age 2 and 18 months. Multiple linear regression analyses revealed that maternal ACEs were associated with increased marital conflict. Neighborhood collective efficacy moderated the association between early maternal ACEs and marital conflict, such that mothers experiencing ACEs had lower levels of marital conflict when exposed to high levels of neighborhood collective efficacy. Results suggest that extra‐familial sources of social support and control, such as feelings of security, trust, order, and connectedness with others, may buffer the effects of early adversity on marital discord.     

A Career Developmental Perspective on the Therapeutic Alliance: Implications for Counseling

This review explores the role played by childhood emotional maltreatment (CEM) in selecting a career in the field of mental health and the potential positive and deleterious effects of these career‐choice motives on the therapeutic alliance. The reviewed findings support the assumption that CEM may serve as a precursor for career choice of professions in the mental health field. Implications are suggested for the counselor/therapist–client relationship, also known as the therapeutic alliance, as well as for career counseling.