Adverse childhood experiences and coping strategies: identifying pathways to resiliency in adulthood

ABSTRACT

Objective

The current study examined whether coping strategies mediate the link between adverse childhood experiences (ACEs) and adult psychiatric and physical health outcomes.     

Trauma‐Informed Programs Based in Schools: Linking Concepts to Practices and Assessing the Evidence

When children experience stress and adversity in their homes and communities, schools become a critically important setting in which to intervene and foster their resilience. Changing practices within schools so that vulnerable and traumatized children are better understood and more compassionately served is a goal shared by many school professionals, yet schools remain poorly equipped to address the needs of these children. Any number of school‐based programs have the potential to benefit children with an elevated risk for academic difficulties and mental health disorders, although questions remain as to which programs are most promising, effective, and sustainable. Questions also remain about which programs best serve diverse populations and which have potential to reach the largest number of children, including those who do not outwardly manifest behaviors consistent with an underlying disorder but nonetheless require support. In this review, we take stock of existing programs used in schools to address the social, emotional, and academic needs of children with trauma histories. We summarize components of a various trauma‐focused programs, categorized as: (a) individual and group‐based approaches, (b) classroom‐based approaches, and (c) school‐wide approaches. For each category, we review and comment on the state and quality of research findings and provide illustrative examples from the literature to show how programs address trauma in the school context. Findings of the review suggest that empirical evidence currently favors individual and group‐based approaches, although classroom‐based and school‐wide programs may be better positioned for integration, access to services, and sustainability. Implications and recommendations center on future research, practice, and policy.     

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.     

Typology,the eight-function model,and archetypal complexes

This clinical presentation shows what insights a typology-conscious analysis of clients and their families may lead to and points out what is added by applying John Beebe’s eight-function, eight-archetype model. To reflect on the inner balance between archetypal complexes in the eight-function structure that holds our psyche, the author invites clients to do a typological analysis, including an analysis of their archetypal patterns, which may, itself, provoke anxiety. This article includes a presentation of ideas and experiences sparked when confronting these complexes in clinical work. Clients are introduced to six stages of coping with stress that may allow them to be more conscious of their complexes when triggered. These stages are Faint, Freeze, Flight, Fidget, Fight, and Flow. To identify whether the stress is physiological, emotional, or intellectual, the idea of the Triune Brain is introduced. The therapeutic work may lead to redemption from opposites, which is an ethical task.     

Adverse adolescence experiences,feeling lonely across life stages and loneliness in adulthood

Background/ObjectiveLoneliness is a mental health issue emerging over the life course. This study examines the latent structure of adult loneliness in a non-Western society and its association with adverse adolescence experiences (AAEs) as well as feeling lonely during middle school, high school, and college. Method: A cohort sample living in Northern Taiwan (N = 2,289) was analyzed from adolescence to adulthood. The de Jong Gierveld Loneliness Scale operationalized loneliness by a three-cluster model to present the latent structure of loneliness: emotional, serious emotional, and severe emotional/social loners. AAEs (e.g., abuse, neglect, and dysfunctional family) were measured by seven items. Multivariate multinomial logistic regression models were used to explore the longitudinal effects of AAEs and feeling lonely reported during middle school, high school, and college on adult loneliness. Results: AAEs and feeling lonely during adolescence were significantly associated with serious emotional loneliness and severe emotional/social loneliness during adulthood, even after adjusting for the individual’s characteristics. Attendance at a 4-year college was associated with decreased odds of serious emotional loneliness and severe emotional/social loneliness. Conclusions: Adults with AAEs and feelings of loneliness over life stages are more likely to report loneliness in the emotional and social domains.     

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.     

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.     

Implementing Trauma-Informed Care in Correctional Treatment and Supervision

ABSTRACT

This article provides a rationale for trauma-informed care (TIC) in correctional services, and challenges readers to think about offending behavior through the lens of trauma. Based on interdisciplinary research and cross-theoretical literature, TIC can help in our quest to develop relevant and successful programs, practices, and policies, and the best methods for delivering them. Using Substance Abuse and Mental Health Services Administration (SAMHSA)’s core principles of TIC, this article will make suggestions for the implementation of trauma-informed service delivery and practices across correctional settings. The authors translate trauma-informed concepts into practice behaviors through the acronym SHARE (safety, hope, autonomy, respect, empathy), which honors the principles of TIC recommended by SAMHSA and the principles of effective correctional rehabilitation. TIC in corrections may help improve the desired outcomes of successful re-entry and reduced recidivism.