Pregnancy is a unique developmental period in a woman’s life, characterized by numerous psychological, behavioural, and biological changes. How a biologically female woman experiences her pregnancy is impacted by her previous life experiences, including early experiences of adversity. In particular, maternal history of Adverse Childhood Experiences (ACEs) before age 18, has been shown to exert distal effects on mental health and behaviour in pregnancy. The current study explored the associations between ACEs and mental health symptoms in pregnancy via structural equation modelling within a sample of 330 Canadian women. This statistical approach permitted the use of a latent ACE variable comprised of abuse, neglect, and household dysfunction as indicator variables, as well as a latent mental health variable comprised of symptoms of depression, anxiety, and fear of childbirth. A direct effect emerged whereby maternal ACEs predicted mental health symptoms. This permitted subsequent testing of the following mediating pathways: sleep, health-risk behaviours, resilience, and social support. In the mediation analyses, further support emerged for the total indirect effect of maternal ACEs on mental health symptoms in pregnancy, once mediation pathways were added. In reviewing individual indirect pathways, sleep and social support mediated the association between ACEs and mental health symptoms in pregnancy. However, health risk behaviours and resilience did not. In addition, social support mediated the relationship between resilience and mental health symptoms in pregnancy. This study contributes to the existing research on maternal ACEs and their relationship with mental health symptoms during pregnancy. The concurrent testing of several pathways in the structural model served to characterize possible mechanisms through which early adversity relates to current mental health symptoms in pregnancy. Implications of these findings include identification of possible targets for intervention in pregnancy, in order to lessen the burden of ACEs on maternal mental health. / Graduate

There are millions of adult male offenders currently involved with U.S. corrections system, many of which report a wide range of mental health difficulties and a history of traumatic experiences. Mental health and trauma-related difficulties are important considerations in the treatment and rehabilitation of adult male offenders. The relationship between adverse childhood experiences (ACEs), attachment style, and PTSD symptoms were studied in a sample of adult male participants in a court-ordered diversion program. The sample consisted of 59 men, ranging in age from 19 to 68-years-old, who endorsed a history of at least one prior arrest. Data were collected during a psychoeducational group-therapy class offered at a post-arrest diversion program. Primary study measures included the use of the ACEs questionnaire, Attachment Style Questionnaire (ASQ-40), and the Posttraumatic Stress Disorder Checklist-5 (PCL-5). A priori hypotheses proposed, 1) there is a significant correlation among ACEs, ASQ subscales, and PTSD symptoms, and 2) insecure attachment subscales mediate the relationship between ACEs and PTSD symptoms. Correlation, regression, and mediation analyses evaluated the relationship among ACEs, ASQ subscales and PCL-5 scores. As predicted, ACEs and PTSD symptoms were negatively correlated with secure attachment and positively correlated with insecure attachment. Also as predicted, insecure attachment style (i.e. discomfort from closeness) mediated the relationship between ACEs and PTSD symptoms. Results suggested that the confidence and discomfort with closeness attachment scales shared a significant relationship between and ACEs and PTSD symptoms. These findings suggest that the relationship between ACEs, attachment style, and PTSD symptomatology can further inform conceptualizations and treatments oriented toward improving outcomes for adult male offenders and successful reintegration into their communities.

Introduction Tennessee (TN) ranked 16th among US states for the number of HIV diagnoses in 2015. By TN grand division region (East, Middle, and West), the highest rate of persons living with HIV/AIDS (PLWH) were in the Middle and West. Barriers to HIV testing are still very much unknown in research studies. Further, understanding how Adverse Childhood Experience (ACEs) play a role in HIV testing and specifically in marginalized groups is not fully understood. The present study sought to understand the relationship between ACEs, living in poverty, and testing for HIV among adults in Tennessee. Methods Behavioral Risk Factor Surveillance System data for 2016 and 2017 were obtained from the Tennessee Department of Health. Sociodemographic factors, diagnosis of depression, binge drinking behaviors, HIV risk behaviors (one or more of these in the past year: injection drug use, anal sex, sex without a condom, paid sex, four or more sexual partners), grand division, poverty level, and ACEs were analyzed to determine if an association exists with having been tested for HIV in the past year (yes or no). ACEs were categorized into 0, one to three, or four or more, all having occurred before the age of 18. Frequencies, percents, chi-square, and independent T-tests were completed. Sex stratified simple and multiple logistic regression models were conducted to determine the strength of association with having been tested for HIV (N=1,506 males; N=1,433 females). Results Males who reported HIV risk behaviors were 46% less likely to be tested for HIV (aOR: 0.54, 95% CI: 0.53-0.55) whereas females with HIV risk behaviors were 61% less likely to test for HIV (aOR: 0.39, 95% CI: 0.39-0.40) compared to those without HIV risk behaviors. Males with 4 or more ACEs were 38% more likely to be tested for HIV compared to males with 0 ACEs (aOR: 1.38, 95% CI 1.36-1.39), whereas females with 4 or more ACEs were two times more likely to be tested for HIV (aOR: 2.09, 95% CI: 2.07-2.11) compared to females with 0 ACEs. Males making <$25,000 annually were only 5% more likely to be tested for HIV (aOR: 1.05, 95% CI: 1.04-1.06), whereas women making the same income were 30% less likely to be tested for HIV (aOR: 0.70, 05% CI: 0.69-0.71) compared to incomes greater than $25,000. Males in West TN were 12% less likely to be tested for HIV compared to males in East TN (aOR: 0.88, 95% CI: 0.87-0.89). Similarly, females in West TN were 15% less likely to be tested for HIV compared to females in East TN (aOR: 0.85, 95% CI: 0.84-0.86). Conclusion Education and awareness may be too focused on adults with more ACEs rather than ensuring individuals with HIV risk behaviors, living in poverty, or residing in West TN, understand their risk and have access to HIV testing. Regions of TN, specifically West TN compared to East TN, may require additional resources to ensure the general population understands their risk for HIV; however further research is warranted through longitudinal studies.

Research has found that adverse childhood experiences (ACEs) are associated with changes in both parenting stress and cortisol. Resilience-building interventions may be able to help diminish the effects of ACEs, thus impacting parenting stress and cortisol reactivity. This study aims to examine how two resilience-building interventions (emotion-based and behavior-based) will impact parenting stress and cortisol reactivity in mothers with ACEs. This project is in the preliminary stages of data collection; as such, this honors thesis will review the relevant literature, describe current methodology and proposed analyses, and discuss possible implications and future directions. Participants (goal N=100) undergo a pre-assessment where parenting stress and cortisol reactivity are measured. Participants are then randomly assigned to receive an emotion-based curriculum (goal n= 50) or behavior-based curriculum (goal n=50) for 8 weeks. After completing their curriculum, participants’ parenting stress and cortisol reactivity will be reassessed. Participants from both resilience-building interventions are hypothesized to have a reduction in parenting stress and cortisol reactivity, but participants who received the emotion-based curriculum are predicted to have greater reductions. Additionally, it is hypothesized that changes in parenting stress will be correlated with changes in cortisol reactivity, so participants with greater reductions in parenting stress are anticipated to have greater reductions in cortisol reactivity.

Background: Long term negative physical and mental health problems occur from the lack of appropriate interventions targeting the adult population who experienced adverse childhood experiences (ACEs) and partake in risky alcohol consumption behaviors. Objective: This study aimed to identify the risk for alcohol consumption behaviors, specifically binge drinking (BD) and any drinking (AD), among adults with a history of adverse childhood experiences (ACEs). Methods: Behavioral Risk Factor Surveillance System (BRFSS) 2011–2012 data were used. Descriptive statistics were completed followed by simple and multiple logistic regression to determine the strength of association between ACEs and alcohol consumption, controlling for sociodemographic factors. Results: The final adjusted sample size was 69,793. Adults who experienced household abuse were 30% more likely to BD (Odds Ratio (OR): 1.30, 95% Confidence Interval (CI): 1.20–1.41) and 21% more likely for AD (OR: 1.21, 95% CI: 1.14–1.28) in the past month. Males were over two times more likely to BD (OR: 2.12, 95% CI: 1.96–2.29) and 60% more likely for AD (OR: 1.60, 95% CI: 1.51–1.69) in the past month compared to females. Individuals who completed some college were at higher risk of BD (OR: 1.51, 95% CI: 1.26–1.82), whereas those who graduated college were nearly two and a half times more likely to report AD in the past month (OR: 2.27, 95% CI: 1.99–2.59) compared to individuals with less than high school education. Conclusion: Adults who experienced household abuse, are male, or possess at least some college education are at increased risk for BD and AD.

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Two of every three students in the classroom today are affected by at least one adverse childhood experience (ACE; Perfect et al., 2016). Recently, researchers have used a neurodevelopmental approach to try to categorize and describe the connection between the neurological, cognitive, and academic success of children with ACEs and may have discovered a unique connection to math (Blodgett & Lanigan, 2018). The culmination of this research suggests that children who experience ACEs develop a stress physiology (as evidenced by differences in brain volume and cortisol levels) and this affects executive functioning. Because executive functioning, which is undergirded by the structural development of the brain (De Bellis et al., 2016), is related to mathematical academic achievement (Clark et al., 2010), children who have structural differences due to ACEs are hypothesized to have unique challenges in math. This study examined children drawn from an academic (rather than clinical) setting using behavioral measures of executive functioning as well as math grades obtained from their schools. Results suggest that for children drawn from a traditional academic setting, having been exposed to ACEs does not predict significant differences in EF skills or in school performance in math. Though the sample demonstrated a typical prevalence of exposure to ACEs, the maternal education of the children in the sample (a proxy for SES) was distinctly high. The interaction of these two aspects of this sample and their implications for the findings is discussed. / Educational Psychology

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Thesis advisor: Rebekah Levine Coley / Research on adverse childhood experiences (ACEs) has demonstrated the high prevalence rates of such experiences, with about 60% of individuals in national U.S. samples reporting one or more types of ACEs as children (Chapman et al., 2013; Finkelhor et al., 2015). Further, research has established robust links between ACEs and a range of negative behavioral and health outcomes in adulthood (Felitti et al., 1998; Hughes et al., 2017; Kalmakis & Chandler, 2015; Wang et al., 2020; Wang & Maguire-Jack, 2018; Wolff et al., 2018). Less is known about when potential negative consequences of ACEs exposure emerge. The few studies that have examined the relationship between ACEs and early outcomes have employed inconsistent modeling strategies which has left the functional form of the relationship unclear, which could lead to either under-or over-estimating the risk associated with various levels of ACEs exposure (Crouch et al., 2019; Hughes et al., 2017; Lanier et al., 2018; Wang et al., 2019). Further, these studies have not comprehensively examined the potential moderating role of socio-ecological factors like neighborhood context. Theoretical frameworks suggest neighborhood resources might buffer children from negative consequences associated with ACEs while exposure to neighborhood-level adversities might exacerbate negative consequences. In order to address these gaps, the currently study examined the functional form of the relationship between ACEs experienced in the first four years of life and kindergarten behavioral outcomes and tested the moderating role of neighborhood resources and neighborhood adversities in a large, nationally representative sample of young children drawn from the Early Childhood Longitudinal Study - Birth Cohort (ECLS-B; N ≈ 10,700) linked with neighborhood administrative data. Using inverse probability weighting to strengthen internal validity, numerous modeling strategies supported a linear relationship between early childhood ACEs and kindergarten behavioral outcomes. Greater ACEs exposure was associated with significantly lower prosocial skills and significantly higher externalizing behavior problems, with small effect sizes of 0.075 to 0.143 standard deviation shifts in behaviors for each additional ACEs exposure. Interaction models found that ACEs were significantly associated with behavioral consequences regardless of neighborhood context. Overall, the robust modeling strategies employed provide the strongest evidence to date of the significant, linear relationship between ACEs and early behavioral consequences. / Thesis (PhD) — Boston College, 2023. / Submitted to: Boston College. Lynch School of Education. / Discipline: Counseling, Developmental and Educational Psychology.