Adverse childhood experiences (ACEs) are associated with poor mental health outcomes, which are increasingly conceptualized from a transdiagnostic perspective. We examined the impact of ACEs on transdiagnostic mental health outcomes in young adulthood and explored potential effect modification. We included participants from the Avon Longitudinal Study of Parents and Children with prospectively measured data on ACEs from infancy till age 16 as well as mental health outcomes at ages 18 and 24. Exposures included emotional neglect, bullying, and physical, sexual or emotional abuse. The outcome was a pooled transdiagnostic Stage of 1b (subthreshold but clinically significant symptoms) or greater level (Stage 1b+) of depression, anxiety, or psychosis – a clinical stage typically associated with first need for mental health care. We conducted multivariable logistic regressions, with multiple imputation for missing data. We explored effect modification by sex at birth, first-degree family history of mental disorder, childhood neurocognition, and adolescent personality traits. Stage 1b + outcome was associated with any ACE (OR = 2.66, 95% CI = 1.68–4.22), any abuse (OR = 2.08, 95% CI = 1.38–3.14), bullying (OR = 2.15, 95% CI = 1.43–3.24), and emotional neglect (OR = 1.68, 95% CI = 1.06–2.67). Emotional neglect had a weaker association with the outcome among females (OR = 1.14, 95% CI = 0.61–2.14) than males (OR = 3.49, 95% CI = 1.64–7.42) and among those with higher extraversion (OR = 0.91, 95% CI = 0.85–0.97), in unweighted (n = 2,126) and weighted analyses (n = 7,815), with an openness–neglect interaction observed in the unweighted sample. Sex at birth, openness, and extraversion could modify the effects of adverse experiences, particularly emotional neglect, on the development of poorer transdiagnostic mental health outcomes.

Although adverse childhood experiences (ACEs) are commonly associated with depressive symptoms in adulthood, studies frequently collapse ACEs into a single unitary index, making it difficult to identify specific targets for intervention and prevention. Furthermore, studies rarely explore sex differences in this area despite males and females often differing in the experiences of ACEs, depressive symptoms, and inflammatory activity. To address these issues, we used data from the National Longitudinal Study of Adolescent to Adult Health to model the effects of 10 different ACEs on C-reactive protein (CRP) and depressive symptoms in adulthood. Path modeling was used to measure the effects of ACEs on CRP and depressive symptoms conjointly while also assigning covariances among ACEs to assess their interrelations. Sex-by-ACE interaction terms and sex-disaggregated models were used to test for potential differences. Emotional abuse and parental incarceration were consistently related to both CRP and depressive symptoms for males and females. Childhood maltreatment was associated with depressive symptoms for females, whereas sexual abuse was associated with inflammation for males. Several covariances among ACEs were identified, indicating potential networks through which ACEs are indirectly associated with CRP and depressive symptoms. These data demonstrate that ACEs have differing direct effects on CRP and depressive symptoms – and that they differ with respect to how they cluster – for males versus females. These differences should be considered in theory and clinical workflows aiming to understand, treat, and prevent the long-term impacts of ACEs on depressive symptoms and inflammation-related health conditions in adulthood.

Adverse childhood experiences (ACEs) are prevalent in people with substance use disorder (SUD). The aims of this study were to determine the prevalence of ACEs in a specific sample of people with SUD and to analyze the specific characteristics of these patients according to gender. The studied sample consisted of 215 people seeking treatment for SUD in two clinical centers in Spain. Descriptive and comparison analyses were carried out, and a logistic regression analysis was conducted to identify the main variables related to ACEs. The prevalence of at least one ACE was 82.3%. Women reported a higher prevalence of family mental health problems (p = .045; d = 0.14) and sexual abuse (p < .001; d = 0.43) than men. The group with ≥3 ACEs showed a higher severity profile for the addiction severity and psychopathological variables than the groups with 0 ACEs and 1–2 ACEs. Logistic regression showed that problems related to the group with ≥3 ACEs in the total sample were psychiatric and legal problems and lifetime suicidal ideation (in men, family/social problems and lifetime suicidal ideation; in women, employment/support problems). This study supports the high prevalence of ACEs in people with SUD and the cumulative effect of ACEs. In addition, gender is a relevant factor. The implementation of assessments and treatment for ACEs is necessary in SUD treatment programs.

Research points to the substantial impact of parents' exposure to adverse childhood experiences (ACEs) on parents and their children. However, most studies have been conducted in North America, and research on ACEs effects on observed parenting or on intergenerational transmission of ACE effects is limited. We therefore studied families from diverse ethnocultural backgrounds in Israel and examined whether mothers’ ACEs hampered maternal sensitivity and the quality of the home environment and whether mothers’ psychological distress mediated these links. We also explored whether mothers’ ACEs predicted children’s behavior problems indirectly through maternal psychological distress and whether maternal sensitivity and the home environment attenuated this mediating path. Participants were 232 mothers (Mchild age = 18.40 months, SD = 1.76; 63.36% non-ultra-Orthodox Jewish, 17.24% ultra-Orthodox Jewish, 19.40% Arab Muslim). Results showed mothers’ ACEs were directly associated with decreased maternal sensitivity. Mothers’ ACEs were indirectly associated with more behavior problems in children through mothers’ higher psychological distress, and maternal sensitivity moderated this indirect link; it was significant only for mothers who showed lower sensitivity. Findings emphasize the significant role ACEs play in early mother-child relationships. The importance of including ACE assessment in research and practice with families of infants and toddlers is discussed.

This study replicated and extended Narayan and colleagues’ (2018) original benevolent childhood experiences (BCEs) study. We examined associations between adverse and positive childhood experiences and mental health problems in a second sample of low-income, ethnically diverse pregnant individuals (replication). We also examined effects of childhood experiences on perinatal mental health problems while accounting for contemporaneous support and stress (extension). Participants were 175 pregnant individuals (M = 28.07 years, SD = 5.68, range = 18–40; 38.9% White, 25.7% Latina, 16.6% Black, 12.0% biracial/multiracial, 6.8% other) who completed standardized instruments on BCEs, childhood maltreatment and exposure to family dysfunction, sociodemographic stress, and perinatal depression and post-traumatic stress disorder (PTSD) symptoms. They completed the Five-Minute Speech Sample at pregnancy and postpartum to assess social support from the other biological parent. Higher family dysfunction predicted higher prenatal depression symptoms, while higher BCEs and prenatal social support predicted lower prenatal PTSD symptoms. Prenatal depression and prenatal PTSD symptoms were the most robust predictors of postnatal depression and PTSD symptoms, respectively, although higher postnatal social support also predicted lower postnatal PTSD symptoms. Findings replicated many patterns found in the original BCEs study and indicated that contemporaneous experiences are also associated with perinatal mental health problems.

Post-traumatic stress disorder (PTSD) is a complex, heterogeneous mental health problem that can be challenging to identify, assess, understand, diagnose and treat. This article provides an overview and critique of key topics, literature and principles to inform comprehensive and meticulous assessment of PTSDs. Although expert witnesses are the target audience, this article will have relevance for identifying, assessing, understanding and diagnosing PTSDs in all clinical contexts. A range of topics relevant to assessment are discussed, including: the complex relationship between trauma and PTSDs; DSM-5-TR PTSD and ICD-11 PTSD and complex PTSD diagnoses and the similarities and differences between them; the clinical presentation of PTSDs; psychological models of PTSDs; how to approach assessment and differential diagnosis; the impact of PTSD on neuropsychological abilities and functioning (disability); causation, reliability and assessing PTSDs when this is being considered as a legal defence; evidence-based interventions (medication, psychological therapy, when is the ‘right time’ for therapy, contraindications); and prognosis (if untreated, how long therapy/change takes). Given ongoing debate, the article proposes that trauma exposure is best defined in future iterations of the DSM and ICD as exposure to one or more psychologically threatening or horrific experiences that are overwhelming.

This study examines associations between early childhood attachment security and adolescent personality functioning in a high-risk sample within a developmental psychopathology framework. Data from 2,268 children (1165 male; 1103 female) and caregivers participating in Future of Families and Child Well-Being Study (FFCWS) were used to examine (1) effects of genetic polymorphisms of the serotonin transporter (5-HTTLPR) and dopamine D4 receptor (DRD4) genes and adverse childhood experiences (ACEs) on attachment security and emotional and behavioral dysregulation in early childhood and (2) longitudinal associations and transactional relationships among attachment security, dysregulation, negative parenting attitudes and behaviors, social competence, and adolescent personality functioning. Results revealed that ACEs predicted attachment security over and above sex or the genetic risk, and gene × environment interactions did not increment prediction. Results of cascade models showed that greater early childhood attachment security predicted higher adolescent level of personality functioning via pathways through intermediary variables. Limitations and future research directions are discussed.

Suicide is a leading cause of death in the United States, particularly among adolescents. In recent years, suicidal ideation, attempts, and fatalities have increased. Systems maps can effectively represent complex issues such as suicide, thus providing decision-support tools for policymakers to identify and evaluate interventions. While network science has served to examine systems maps in fields such as obesity, there is limited research at the intersection of suicidology and network science. In this paper, we apply network science to a large causal map of adverse childhood experiences (ACEs) and suicide to address this gap. The National Center for Injury Prevention and Control (NCIPC) within the Centers for Disease Control and Prevention recently created a causal map that encapsulates ACEs and adolescent suicide in 361 concept nodes and 946 directed relationships. In this study, we examine this map and three similar models through three related questions: (Q1) how do existing network-based models of suicide differ in terms of node- and network-level characteristics? (Q2) Using the NCIPC model as a unifying framework, how do current suicide intervention strategies align with prevailing theories of suicide? (Q3) How can the use of network science on the NCIPC model guide suicide interventions?

Early childhood trauma has been linked to neurocognitive and emotional processing deficits in older children, yet much less is known about these associations in young children. Early childhood is an important developmental period in which to examine relations between trauma and executive functioning/emotion reactivity, given that these capacities are rapidly developing and are potential transdiagnostic factors implicated in the development of psychopathology. This cross-sectional study examined associations between cumulative trauma, interpersonal trauma, and components of executive functioning, episodic memory, and emotion reactivity, conceptualized using the RDoC framework and assessed with observational and performance-based measures, in a sample of 90 children (ages 4–7) admitted to a partial hospital program. Children who had experienced two or more categories of trauma had lower scores in episodic memory, global cognition, and inhibitory control as measured in a relational (but not computerized) task, when compared to children with less or no trauma. Interpersonal trauma was similarly associated with global cognition and relational inhibitory control. Family contextual factors did not moderate associations. Findings support examining inhibitory control in both relationally significant and decontextualized paradigms in early childhood, and underscore the importance of investigating multiple neurocognitive and emotional processes simultaneously to identify potential targets for early intervention.

Despite the challenges associated with motherhood, studies have not consistently identified factors contributing to first-time mothers’ dissatisfaction with motherhood in resource-limited regions. To fill this research gap, this study investigates how adverse childhood experiences (ACEs) result in first-time mothers’ dissatisfaction with motherhood through emotional distress in Nigeria. Results from the partial least square structural equation model suggests that ACEs are associated with dissatisfaction with motherhood ($ \beta $ = 0.092; p < 0.01) and emotional distress ($ \beta $ = 0.367; p < 0.001). There is also a significant association between emotional distress and dissatisfaction with motherhood ($ \beta $ = 0.728; p < 0.001). Indirect path from first-time mothers’ ACEs to dissatisfaction with motherhood through emotional distress shows significance ($ \beta $ = 0.267; 95% CI (0.213, 0.323); p < 0.001). In addition, the indirect path from first-time mothers’ ACEs to dissatisfaction with motherhood through child emotional closeness showed significant dampening effects ($ \beta $ = 0.044; 95% CI (0.025, 0.066); p < 0.001). No serial impact of emotional distress and child emotional closeness was found in the study. The findings based on child gender indicated that only among first-time mothers of female children are ACEs predictors of dissatisfaction with motherhood. Trauma-informed interventions should be introduced in primary care settings to screen for ACEs and emotional dysfunctions among first-time mothers.