Relationship between Adverse Childhood Experiences and Illness Perceptions among Individuals with Fibromyalgia by Susan D. Fay MS, Drexel University, 1994 BS, Metropolitan State University of Denver, 1983 Dissertation Submitted in Partial Fulfillment of the Requirements for the Degree of Doctor of Philosophy Psychology Walden University February 2015 Adverse childhood experiences (ACEs), including abuse and neglect, are a significant social health problem. Exposure to ACEs can place a child at a high risk for developing different diseases or illnesses in adulthood, including fibromyalgia. The purpose of this study was to determine if exposure to ACEs, moderated by perceived social support and/or social undermining, would result in more negative illness perceptions of personal control and/or treatment control. A survey research design was used in this quantitative study. Purposive convenience sampling methods were used to solicit 231 participants to complete an online survey. Moderated multiple regression analysis was used to assess the moderating roles of perceived social support and social undermining on the relationship between ACEs with personal control and treatment control facets of illness perceptions among individuals with fibromyalgia. Developmental traumatology, allostatic load, social support, social undermining, and illness perceptions served as the theoretical and empirical foundation for this study. Social undermining was found to be a significant moderator of the relationship between sexual abuse, perceived social support, and personal control perceptions, F(7, 174) = 1.28, p <.001, but only when levels of social undermining were moderate to high. The relationship was not significant for treatment control perceptions as the criterion variable, or for physical or emotional abuse as predictor variables. Positive social change implications include an expanded knowledge of important social and psychological factors that influence the health of fibromyalgia patients, especially those exposed to sexual abuse. Such information can assist health care providers develop more effective therapies, treatments, and screening protocols.

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Background: Exposure to greater Adverse Childhood Experiences (ACEs) has been associated with increased likelihood of general and sex offending behaviors. However, few studies consider both the impact of varied ACE exposures and other early experiences on pathways to offending behaviors in adolescents who have engaged in sexually abusive behaviors. Objective: The purpose of this study was to examine the impact of ACEs and sexual boundary problems within the home on the development of delinquent and sexually abusive behavior. Participants & setting: Data were collected from archival records of male adolescents (N = 285) who had received treatment for sexually abusive behavior at a youth facility. Methods: This study investigated the effects of individual adverse experiences on delinquent nonsexual and sexually abusive behaviors through structural equation modeling. Results: Structural equation modeling revealed a three-factor model for ACEs. Direction and significance of paths between ACEs and the onset, persistence, and nature of maladaptive behaviors differed. Household dysfunction was related to an earlier onset (β = 1.19, p = 0.013) and more persistent nonsexual delinquent offending (β = 1.05, p = 0.048) and contact sexual offending (β = 1.19, p = 0.010). Conversely, sexual abuse and exposure to sexual boundary problems were associated with an earlier onset of sexually abusive behavior (β = −1.08, p = 0.038) as well as indicators of adolescent-onset (β = −1.30, p = 0.002), less persistent (β = −1.53, p = 0.001), and nonviolent (β = −1.89, p = 0.001) delinquency. Conclusions: Findings suggest variations in ACE exposures differentially influence the onset, severity, and persistence of delinquent and sexually abusive behaviors among these youths.

This thesis evaluated the Trauma-Informed Child Advocacy Certificate (TICA) at Mississippi State University which is hosted in the School of Human Sciences, specifically in the area of Human Development and Family Science (HDFS). HDFS students (N = 94) enrolled in coursework during Spring 2021 participated in the evaluation. Students were grouped by enrollment in TICA courses, with 43 students having participated in TICA coursework and 51 students having only participated in general HDFS courses. Assessments included a perceived knowledge survey and 10 application-based scenarios. Independent samples T-tests indicated TICA students perceived themselves to have more trauma-informed knowledge, and frequency analyses showed they were more effective at applying that knowledge than HDFS students who have not taken any TICA courses. Data were used to highlight strengths of the TICA program and make recommendations on ways to enhance the TICA coursework to promote knowledge of trauma-informed professional practices.

School-age children are at high risk of experiencing traumatic and stressful events that can negatively impact their academic, emotional, and behavior performance (Brock et al., 2016). Any stressful situation (i.e., natural disaster) or adverse childhood experience (ACE) can potentially become a traumatic event for a child or adolescent. The current literature indicates that 60% of children experience at least one ACE, putting them at high risk for a variety of health and social problems (Manyema et al., 2018). Natural disasters adversely impact children's life as they have the potential to destroy physical structures and injure the child or family members. According to Inoue and colleagues (2018) natural disasters can additionally be considered as an ACE. The purpose of this study was to explore the relationship between PTSD symptoms of students who have experienced a natural disaster (e.g., hurricane exposure) and students’ internalizing and externalizing behaviors. Participants included 75 students from elementary, middle, and high school in a school district in the Southeastern United States. Linear regression showed that PTSD symptoms are significantly correlated with internalizing and externalizing behaviors. However, moderation and interaction effects showed that he type of hurricane exposure did not significantly moderate the relationship between PTSD symptoms and students' internalizing and externalizing behaviors. Implications from these results suggest that trauma-informed strategies are needed for students that are exposed to a traumatic event.

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Adult depression is a common consequence of adverse childhood experience. There is also a higher likelihood of being affected by economic burdens after having expierienced a traumatic event in childhood. As depression has been associated with economic burden, these long-term sequelae of childhood adversity are likely to interact. We investigated depression and economic consequences, such as unemployment, lower level of education, lower income as long term sequelae of adverse childhood experiences in adulthood and their interaction. Childhood Maltreatment was measured by the German version of the Adverse Childhood Experience (ACE) questionnaire. Depression was measured by the Patient Health Questionnaire (PHQ-2). Logistic regressions were applied to investigate the risks of suffering economic burdens, with depression as a moderator. Depressive symptoms increased with the number of ACEs and were highest in those reporting four or more ACEs, especially amongst those who experienced sexual and emotional abuse, as well as neglect. Moderation analysis showed a significant effect of depression incresing almost all economic burdens. Migration background additionally increased the risk of unemployment and working in a blue-collar job. Female gender decreased the risk of unemployment and working in a blue-collar job, but increased the risk of low income and part-time employment. The moderation effect of depression increased the negative impact of exposure to multiple ACEs on economic life in adulthood. Prevention of ACEs and early intervention are needed to prevent the mental health and economic consequences.

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