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Domain V: Public Policy and Environmental Change
Published in Nicole M. Augustine, Prevention Specialist Exam Study Guide, 2023
I want to take a moment to talk about Adverse Childhood Experiences (ACEs). Trauma, historical trauma, and Adverse Childhood Experiences are something that both research and practice in the field of substance misuse prevention, must begin to understand. That's because those who have experienced ACEs are more likely to experience problematic substance use as a result. Therefore, understanding how they can work together can bring about better results for all those involved. Although you won't be tested on ACEs, this is an important concept for improving prevention practice.
Influences affecting and impacting on the health and wellbeing of children
Published in Jackie Musgrave, Health and Wellbeing for Babies and Children, 2022
Adverse Childhood Experiences (ACEs), as the title suggests, are negative events such as bereavement and domestic abuse within families (discussed in Chapter 7). The presence of ACEs follows a social gradient, meaning that there is a higher incidence of children who experience ACEs in poorer families and the impact on children's health, especially mental health can be greater. However, it is important to point out that ACES can of course happen to all children regardless of the socio-economic status, but the impact can be mitigated by the support that is available to the family and children. The incidence or impact of ACEs on children's health can be reduced with appropriate support, those families with narrow and shallow support systems are more vulnerable. Marmot points out that ACEs ‘tend to cluster’ (2015, p. 119) meaning that the experiences that cause adversity in childhood such as violence in the family or a parent with addictions often occur in parallel. For many children around the world, the effects of the restrictions caused by the pandemic will have been an adverse experience.
Lifestyle Medicine in the Care of Adolescent Girls
Published in Michelle Tollefson, Nancy Eriksen, Neha Pathak, Improving Women's Health Across the Lifespan, 2021
Neeta B. Agarwal, Michelle Dalal
Stress has been described by Hans Selye as the body’s nonspecific response to any demand. Distress refers to stress caused by unpleasant stimuli, whereas eustress refers to stress caused by positive experiences. Teen years are a time of new experiences and many “firsts”, and as such, there is considerable distress and eustress along the way. External stressors abound – academic demands and career planning, social stressors including friendships, relationships, and peer pressure, possibly financial struggle and need for balancing employment with school, and injury or illness for some. Internal sources of stress – those that occur within us – originate from expectation and our mindset. For teens, internal stress includes identity formation, gender concerns, development of values and beliefs, role in family, and self-image. Spending one-on-one time during well visits provides opportunity for teens to share about these stressors. Screening tools include the Perceived Stress Scale (PSS) and the Pediatric ACEs (adverse childhood experiences) and Related Life Events Screener (PEARLS). Screening for mood with the Patient Health Questionnaire (PHQ-9) for depression, the Generalized Anxiety Disorder (GAD-7) Question Screener for anxiety, and the Ask Suicide-Screening Questions (ASQ) may also help identify mood concerns which contribute to stress. Screening for anxiety and depression is important at least once annually at well visits.
The Unpopular Victims: Individuals Who Are Sexually Abusive – The Black Swans
Published in Journal of Child Sexual Abuse, 2023
The well-known Adverse Childhood Experience (ACEs) study (Felitti et al., 1998) has established that experiencing ongoing trauma produces longstanding problems that compromise health and psychological development. These problems also contribute to a discernible lack of empathy and lethargy of intimacy (i.e., apathy and non-responsiveness) (Miccio-Fonseca, 2018). Felitti et al. categorized ACEs as including abuse, neglect, and other household dysfunction (e.g., substance abuse, mental health problems, domestic violence, and criminal behavior). The ecology of such home environments is not fertile ground for promoting trust, respect, and feeling valued. The familial ambience is apt to manifest a deficiency of overall attentiveness, with parents and/or other caregivers failing to attend to specifics of the immediate environment (i.e., inadequate and unsafe shelter; inadequate clothing for the child) and creating significant risk factors for persistent coarse sexual improprieties that reflect an unsophisticated awareness of psychosexual conditions, environments, or social situations and/or sexually abusive behaviors that fall along a coercion continuum of low, moderate, high, or very high (lethal) risk. This applies to youth who are sexually abusive who are either adjudicated or non-adjudicated.
Adult outcomes for children who sustained firearm-related spinal cord injuries
Published in The Journal of Spinal Cord Medicine, 2023
Jessica Pruente, Allen W. Heinemann, Kathy Zebracki, Shubra Mukherjee, Deborah Gaebler-Spira
Gun injuries disproportionately affect those from lower socioeconomic groups. Community factors that predict gun violence include lower rates of adults with a high school diploma, increased poverty rate, and decreased median income.4 Exposure to adverse childhood experiences (ACEs), such as gun violence, increases the risk of multiple adverse health outcomes including alcohol and drug abuse, depression, ischemic heart disease, cancer, and liver disease.5 Increasing exposure to violence, neglect, or abuse increases the risk of interpersonal or self-directed violence and negative behavioral health outcomes.6 Additionally, exposure to ACEs is associated with self-reported disability in adulthood, even when controlling for other health comorbidities.7
Clinic screening for adverse childhood experiences in people living with HIV to Improve Care Delivery
Published in AIDS Care, 2022
Priyanka Anand, Jennifer Wilson, Bryce Carter, Abby Bronstein, Alexis Schwartz, Brittney Harrington, Tracey Adams, M. Elle Saine, Anne Norris, David Metzger, William R. Short, Jessie Torgersen
Integration of trauma-informed services in medical care, including screening for past trauma, improves the healthcare experiences of vulnerable patients and is essential in HIV care (Machtinger et al., 2019; Whetten et al., 2008). Adverse childhood experiences (ACEs) represent a group of potentially traumatic events that occur during the first 17 years of life (Felitti et al., 1998). These ACEs can adversely impact adult health through the development of an altered biologic stress response via chronic hypothalamic–pituitary–adrenal axis dysfunction and manifestation of maladaptive coping mechanisms (Felitti et al., 1998; Oral et al., 2016). Trauma histories, and accompanying stress and mental illness, are associated with a number of poor HIV-specific outcomes, including increased health risk behaviors, substance use, and lack of viral suppression; yet, screening for trauma histories, including ACEs, among people living with HIV (PLWH) is not routinely performed in routine clinical care (Blashill et al., 2011; K. Campbell et al., 2019; Leserman, 2008; Meade et al., 2009; Pence et al., 2012; Sledjeski et al., 2005).