The empirical investigation of adverse childhood events (ACEs) and their relationship with health and well-being outcomes in later life is increasing. Less is known about factors that may promote resilience for those who have survived such challenges, such as how resilience may be facilitated for those with ACEs residing in a marginalized region such as South Central Appalachia. Multidimensional spirituality, social support, stigma related to ACEs, and Appalachian acculturation may serve as both valid cultural factors and potential indicators of resilience. Cross-sectional, simultaneous multiple regression analysis was performed on data collected from 272 adult patients of a South Central Appalachian based medically assisted treatment (MAT) program utilizing PROCESS macro (Hayes, 2018). Participants were 53.8% male, 94.4% Caucasian, 44.9% aged 35-50 years old, and 63.6% employed. Endorsement of increased spirituality was helpful for those in MAT in South Central Appalachia who self-reported ACEs. However, as one endorsed an increasing number of ACEs, spirituality was no longer salient but instead was associated with worsened health outcomes and lessened hope. The three dimensions of spirituality (Ritualistic, Theistic, and Existential) moderated these relationships in similar but nuanced ways. Social support, on the other hand, improved mental health regardless of ACE score. Stigma and Appalachian acculturation were only related to other variables at the bivariate level but not within the hypothesized moderation model. Our study offers preliminary insight into culturally relevant resilience within South Central Appalachia, however additional investigation is needed to better understand the complex facets of health and well-being outcomes in this marginalized region.

Children and adolescents that reappear for investigation in the Child Protective Services (CPS) can be interpreted as an issue for the social services ambitions to provide service for potential families in need of assistance. This study was based on information gathered from social workers investigating the situation for 882 children during two months, in two municipalities in Sweden. The aim of the study was to investigate the relationship between adverse childhood experiences and being the subject of more than one previous investigation at the CPS. The study provides an estimate of the likelihood of  being the subject of more than one previous investigation. Results show that certain adversities concerning the child and in the family situation increased the odds of having been exposed to several investigations. Findings from the study also show that the risk of being investigated several times increases incrementally with accumulated adverse childhood experiences.

This Q methodology study focused on those intrinsic attributes that successful African American men who had adverse childhood experiences attributed to their success. Using the purposeful and snowball sampling recruitment process, forty-two successful African American men participated in this research project. Five distinct factors were identified and labeled as, Factor 1: The Godly Working Men, Factor 2: The Competitive Men, Factor 3: The Charismatic Men, Factor 4: The Expectation Driven Men, and Factor 5: The Proud African American Men. The main findings were that respectful African American boys who are taught to understand who they are spiritually, be proud of their racial history, have a sound sense of purpose, and a desire to work hard are tooled to become successful African American men. The findings in this study support the wealth of research regarding strength-based youth development approaches, such as the Positive Youth Development’s 40 Developmental Assets framework. The six top intrinsic attributes that the participants in this research project ranked as most contributing to their success were 1) faith and trust in God, 2) desire to learn and understand how to apply the word of God to their life, 3) being respectful of others, 4) having a sense of purpose and value for life, 5) pride in racial identity and history, and 6) the ability to work hard and do their best. However, the intrinsic attributes relating to spirituality and pride in racial identity and history are not explicitly identified within the internal assets of the Positive Youth Development’s 40 Developmental Assets framework. For this framework to be meaningful for African Americans, the pride in racial identity and history attribute should be added to the positive identity group and a new group should be included to account for the two spirituality attributes. This study provided evidence that African American men from adverse backgrounds have voices and want to share their experiences to help other young people overcome and be successful. It is highly recommended that additional study be conducted on the impacts that extrinsic and intrinsic attribute have to the success of African American men.

Introduction. La notion d'" embodiment " propose que chaque humain est à la fois un être social ainsi que biologique, intégrant le monde dans lequel il/elle vit. Nous faisons l'hypothèse que la position socioéconomique pendant l'enfance peut être biologiquement incorporée, conduisant à la production des inégalités sociales de santé entre les sous-groupes de population. La charge allostatique (CA) est un concept qui tente de capturer l'usure physiologique globale du corps liée à l'activation répétée des mécanismes physiologiques compensatoires en cas d'exposition à des stress chroniques. La CA pourrait permettre une meilleure compréhension des voies biologiques qui jouent un rôle potentiel dans la construction du gradient social de santé des adultes. Objectif. Pour explorer l'hypothèse d'incorporation biologique, nous avons examiné les voies de médiation entre les adversités psychosociales et la position socioéconomique précoces et la CA à 44 ans. Nous avons également confronté l'indice de CA à une mesure multidimensionnelle de santé latente à 50 ans. Méthodes. Les données sont issues de la cohorte Britannique de naissance de 1958 (n=18 000). La CA a été construite avec les données de l'enquête biomédicale conduite à 44 ans, comme une mesure physiologique synthétique, multi-système, à l'aide de 14 biomarqueurs représentant les systèmes neuroendocrinien, métabolique, immunitaire / inflammatoire et cardiorespiratoire. Résultats. L'ensemble de nos résultats suggèrent que la CA pourrait être un indice approprié pour capturer partiellement la dimension biologique des processus d'embodiment. Discussion. Comprendre comment l'environnement affecte notre santé en se " glissant sous la peau " et pénétrant dans les cellules, les organes et les systèmes physiologiques de notre corps est un principe clé dans la recherche en santé publique. Promouvoir le recueil de marqueurs biologiques dans des grandes études prospectives et représentatives est crucial pour continuer la recherche sur ce sujet. Les études de réplication pourraient faire partie des futures perspectives de recherche, pour comparer entre populations avec des contextes culturels différents pour observer si un index de CA peut être considéré comme "universel ". / Introduction. The notion of embodiment proposes that every human being is both a social and a biological organism that incorporates the world in which (s)he lives. It has been hypothesized that early life socioeconomic position (SEP) can be biologically embedded, potentially leading to the production of health inequalities across population groups. Allostatic load (AL) is a concept that intends to capture the overall physiological wear-and-tear of the body triggered by the repeated activation of compensatory physiological mechanisms as a response to chronic stress. AL could allow a better understanding of the potential biological pathways playing a role in the construction of the social gradient in adult health. Objective. To explore the biological embedding hypothesis, we examined the mediating pathways between early SEP and early adverse psychosocial experiences and higher AL at 44 years. We also confronted an AL index with a latent multidimensional and integrative measure of health status at 50y. Methods. Data are from the 1958 British birth cohort (n=18 000) follow-up to age 50. AL was operationalized using data from the biomedical survey collected at age 44 on 14 parameters representing the neuroendocrine, metabolic, immune-inflammatory and cardiovascular systems. Results. Overall, our results suggest that AL could be a suitable index to partially capture the biological dimensions of embodiment processes. Discussion. Understanding how human environments affect our health by 'getting under the skin' and penetrating the cells, organs and physiological systems of our bodies is a key tenet in public health research. Promoting the collection of biological markers in large representative and prospective studies is crucial to continue to investigate on this topic. Replication studies could be part of the future research perspectives, to compare with other cultural context and to observe if an AL index can be 'universal'.

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Syftet med studien var att undersöka hur känsla av sammanhang (KASAM) påverkas i vuxenlivet hos individer som farit illa i barndomen. Tidigare forskning tydliggör vilken omfattande problematik det kan vara. Vidare undersöker studien betydelsen av vändpunkter och motståndskraft för posttraumatiskt växande. Den kvalitativa metoden består av sex semistrukturerade intervjuer. Den kvantitativa metoden innefattar en webbenkät där 101 respondenter deltog. Antonovskys KASAM tillsammans med Mays existentialism och Honneths erkännandeteori lägger grunden för studiens teoretiska ansats. Resultatet visar att en förlust av grundtillit och egenvärde i barndomen leder till en svag känsla av sammanhang. Urvalsgruppens KASAM-värden var avsevärt lägre än normalbefolkningens, dock med hög meningsfullhet. I vuxenlivet tycks det viktigt att ta igen barndomens förluster. Samtalsstöd med ett salutogent synsätt kan kompensera för denna förlust. Det tillsammans med meningsskapande processer kan leda till posttraumatiskt växande. / The aim of this study was to examine how sense of coherence (SOC) is affected in adulthood in people who have suffered from adverse childhood experiences. Previous research indicate on how comprehensive of a problem this is. We also wanted to examine the impact of turning points and resilience for posttraumatic growth. The qualitative method consists of six semi- structured interviews. The quantitative method is composed of a web survey in which 101 respondents participated. Antonovsky's SOC together with May's existentialism and Honneth's theory of recognition lays the foundation for the study's theoretical approach. The result shows that a loss of basic trust and intrinsic value in childhood leads to a low sense of coherence. Participants SOC values was significantly lower than the normal population, however they scored high on meaningfulness. In adulthood it seems important to reclaim these losses from childhood. Different types of counseling with a salutogenic approach can make up for that loss. This, together with meaning-making, can lead to posttraumatic growth.

Survivors of complex childhood trauma (CCT) tend to develop distinctive mental health challenges later on in adulthood, which may be exacerbated by the ongoing coronavirus pandemic. CCT survivors often struggle with self-regulation, making it difficult to tolerate the distress associated with “gold-standard” trauma-processing therapies for survivors of single-incident and adult-onset trauma. Yoga can enhance self-regulation, through physical movements, breathing techniques, meditative focus, and ethical guidelines of behaviour. This dissertation encompasses the creation of a new approach for teaching yoga to trauma survivors, called TIME yoga. This approach is based on a neuropsychological understanding of the bio-psycho-social alterations that CCT survivors undergo. Chapter 1 details the methods employed in this series of dissertation studies. A randomized controlled trial (RCT) was conducted with 26 adult survivors of CCT. Mental health, emotional functioning, resilience, and cognitive functioning were assessed via subjective and objective measures at two time points (i.e., pre- and post- participation in the online yoga program or waitlist). Chapter 2 is a retrospective and cross-sectional study describing survivors’ pre-intervention psychological and cognitive functioning during the pandemic, and evaluating the impact of trauma at particular developmental stages. Regression analyses revealed particular implications of adolescent and young-childhood trauma. Chapter 3 presents a manual of TIME yoga and feasibility data from the initial RCT, supporting both feasibility and safety of the program. Chapter 4 underscores yoga-related improvements in depressive symptoms, interoceptive awareness, and executive functioning. Using both repeated-measures ANOVAs and clinically meaningful indicators of change, this study illustrates how TIME yoga effectively improved survivors’ self-regulation during the global health crisis. Future directions for program development and evaluation are discussed. / Graduate / 2023-04-11

Today’s elementary school students face myriad traumatic issues including poverty, violence, physical and emotional abuse, homelessness, and parental substance abuse. These adverse childhood experiences are responsible for an increased risk of academic failure and behavioral problems in childhood, adolescence, and into adulthood. Social-emotional learning (SEL) programs, provided through school and community partnerships, attempt to address these needs in both school-based and out-of-school-time (OST) learning settings. The purpose of this action research study was to examine one northern California-based nonprofit organization’s OST SEL program for third through fifth grade students and determine actions and interventions for greater program effectiveness. Students, parent/guardians, site administrators, school-staff, and community members engaged in focus groups, completed surveys, participated in validation groups, and acted as research associates throughout the iterative plan, act, observe, reflect action research cycle conducted during the winter of 2020. Qualitative data from focus group meetings included identified themes from authenticated and coded transcripts while quantitative data included descriptive statistical analysis of pre-program and end-of-program surveys. As the lead researcher for the study, I worked with action research participants to make program modifications and identify new actions for program improvement. Based on themes and data trends, as well as the application of self-determination theory’s basic psychological needs theory, findings demonstrate that student self-management skills improved during the 4-week action research cycle, as did their sense of autonomy, competence, and relatedness. At the same time, findings suggest additional growth opportunities in the areas of responsible decision-making and program improvement through development and implementation of integrated and universal SEL supports in classrooms, schools, families, and the larger community. Linking the literature to these findings, recommendations for future action research cycles include age and developmental considerations regarding instruction and application of responsible decision-making skills, and integration of all five SEL competencies for greater harmonization of emotion and thought. To that end, the nonprofit organization’s educational design team and I have begun redesigning the curriculum. Program modifications address child development of perceptual and higher-level memory and cognitive skills, and intentional integration of instruction and practice in all five SEL competencies throughout each program module. Teaching, combined with real-time application of planning and decision-making skills, will include opportunities for active role-playing, adult guidance, and experiences in which students learn and grow from mistakes. In addition to student program modifications to build responsible decision-making skills, literature supports the call for universal SEL in the form of partnerships between schools, families, and community organizations for resource coordination resulting in more positive youth outcomes. Again working with the educational design team, the nonprofit organization and I have taken initial steps to establish a city wellness task force, bringing together a diverse group of stakeholders to partner in wellness for children and families in the community. We also continue to iterate as we develop a community of practice for educators, focused on building SEL knowledge and practice. By focusing on continuous improvement through an ongoing action research process, this study not only serves as an opportunity to celebrate successes, but highlight growth opportunities to advance the work of the northern California-based nonprofit organization and its programs. Utilizing study findings in combination with supporting literature, we are taking immediate action towards more positive outcomes for those we serve. This study also provides tools and guidance for other community partners in their design and implementation of effective SEL programs for the social and emotional well-being of elementary school students and families, and the communities in which they live.

Abstract Adverse Childhood Experiences and Trauma-Informed Schools: Restorative Practices for Social and Emotional Behavior Issues in Education by Heather Easterling The purpose of this study was to determine whether factors in school climate and culture and the educator's role in evaluating adverse childhood experiences (ACEs), trauma-informed situations, and disruptive classroom behaviors, enable a school to generate interventions needed to help students succeed. This qualitative study evaluated the ACEs and the relationships traumatic incidents had on disruptive classroom behaviors that teachers experienced with students. Although there is emerging research regarding ACEs and trauma-informed schools, there are multiple factors that facilitate the relationship between ACEs and disruptive classroom experiences. Data collection strategies included the use of interview procedures and document review. This evidence was gathered from teachers who provided their experiences with disruptive classroom behaviors and their experiences with behavior intervention programs such as RTI2B (Response to Instruction and Intervention for Behavior) and trauma-informed practices. Analysis of data occurred in three phases: (a) categorization based on emergent themes from the interviews, (b) constructing the explanation in narrative form, and (c) re-examination of the collected data concerning discipline referrals, school climate surveys, and attendance surveys. This research study provided insight into experiences teachers had with disruptive classroom behaviors. The experiences showed implementation of trauma-informed practices, a positive behavior program, and the need for a support system for teachers to be able to better reach students who have experienced ACEs that are related to disruptive classroom behaviors. The results revealed that there were direct factors that determined that the relationship between ACEs and trauma were consistent with disruptive classroom behaviors.

Prior research suggests a greater degree of suicidality and self-harm behavior in those involved with criminal justice and forensic mental health systems. Such individuals also evidence increased exposure to early childhood adversity, which is often associated with suicide risk. Other significant predictors of suicidality have been noted within forensic populations, however, including indicators of specific psychopathology and situational and demographic factors. These populations present with overlapping risk factors that remain underexamined. In the current study, 182 persons residing in secure forensic psychiatric care following incidents of illegal and aggressive behavior were evaluated. Adverse childhood experiences and other empirically derived potential predictors of suicide attempts and self-harm were examined via binomial logistic regression. Findings indicate frequent experiences of early adversity across participants, and that a combination of race, individual adverse childhood experiences, number of biological children, and diagnoses of either posttraumatic stress disorder or borderline personality disorder were significant predictors of suicide attempts, self-harm behavior, and first hospitalization resulting from a suicide attempt. Clinical and research implications are discussed.