Adverse childhood experiences: Assessing the impact on physical and psychosocial health in adulthood and the mitigating role of resilience.


Journal

Child abuse & neglect
ISSN: 1873-7757
Titre abrégé: Child Abuse Negl
Pays: England
ID NLM: 7801702

Informations de publication

Date de publication:
05 2020
Historique:
received: 22 09 2019
revised: 24 02 2020
accepted: 27 02 2020
pubmed: 7 3 2020
medline: 15 7 2021
entrez: 6 3 2020
Statut: ppublish

Résumé

More than 2000 studies demonstrate adverse childhood experiences ACEs are universal and that experiencing multiple ACEs increases risk for developing physical and psychosocial health problems in adulthood. A challenge faced by clinicians is identifying those most at risk. Recent evidence suggests socio-ecological resilience may mitigate the consequences ACEs. We hypothesize that integrated assessment of ACEs and resilience might improve identification of those at highest risk. We examined ACEs among adults attending a rural family practice clinic and explored associations between ACE, socio-ecological resilience and health. A cross-sectional survey measured ACEs, resilience, and health in adult patients attending a collaborative family health care centre in Lunenburg, Nova Scotia, Canada. Correlation analyses were used to determine associations between the measures. The impact of socio-economic status, level of education and gender was considered. Two hundred and twenty-six persons participated in this study. Approximately 73 % of participants had experienced at least one ACEs and 31 % experienced 4 or more. Overall with increasing numbers of ACEs prevalence of health problems increased. However, individuals with high resilience scores had lower prevalence of health problems. Regression analyses indicated that the number of ACEs were slightly more important predictor of health issues than level of resilience, though both were important. Social economic status, education level and gender were not significant predictors of the impact of ACEs on person's health. The results suggest integrated assessment for resilience and ACEs may facilitate identification of those at higher risk and in need of preventative intervention.

Sections du résumé

BACKGROUND
More than 2000 studies demonstrate adverse childhood experiences ACEs are universal and that experiencing multiple ACEs increases risk for developing physical and psychosocial health problems in adulthood. A challenge faced by clinicians is identifying those most at risk. Recent evidence suggests socio-ecological resilience may mitigate the consequences ACEs. We hypothesize that integrated assessment of ACEs and resilience might improve identification of those at highest risk.
OBJECTIVES
We examined ACEs among adults attending a rural family practice clinic and explored associations between ACE, socio-ecological resilience and health.
METHODS
A cross-sectional survey measured ACEs, resilience, and health in adult patients attending a collaborative family health care centre in Lunenburg, Nova Scotia, Canada. Correlation analyses were used to determine associations between the measures. The impact of socio-economic status, level of education and gender was considered.
RESULTS
Two hundred and twenty-six persons participated in this study. Approximately 73 % of participants had experienced at least one ACEs and 31 % experienced 4 or more. Overall with increasing numbers of ACEs prevalence of health problems increased. However, individuals with high resilience scores had lower prevalence of health problems. Regression analyses indicated that the number of ACEs were slightly more important predictor of health issues than level of resilience, though both were important. Social economic status, education level and gender were not significant predictors of the impact of ACEs on person's health.
CONCLUSION
The results suggest integrated assessment for resilience and ACEs may facilitate identification of those at higher risk and in need of preventative intervention.

Identifiants

pubmed: 32135375
pii: S0145-2134(20)30095-8
doi: 10.1016/j.chiabu.2020.104440
pii:
doi:

Types de publication

Journal Article Research Support, Non-U.S. Gov't

Langues

eng

Sous-ensembles de citation

IM

Pagination

104440

Informations de copyright

Crown Copyright © 2020. Published by Elsevier Ltd. All rights reserved.

Auteurs

Nancy Ross (N)

School of Social Work, Dalhousie University, Halifax, Nova Scotia, Canada. Electronic address: nancy.ross@dal.ca.

Robert Gilbert (R)

School of Health Sciences, Dalhousie University, Halifax, Nova Scotia, Canada.

Sara Torres (S)

School of Social Work, Laurentian University, Sudbury, Ontario, Canada.

Kevin Dugas (K)

School of Social Work, Dalhousie University, Halifax, Nova Scotia, Canada.

Philip Jefferies (P)

Resilience Research Centre, Dalhousie University, Halifax, Nova Scotia, Canada.

Sheila McDonald (S)

Maternal Child Health-Research and Innovation Population, Public and Indigenous Health Alberta Health Services/University of Calgary, Nova Scotia Health, Canada.

Susan Savage (S)

Nova Scotia Health Authority, Nova Scotia, Canada.

Michael Ungar (M)

Resilience Research Centre, Dalhousie University, Halifax, Nova Scotia, Canada.

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