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Individuals exposed to abuse, neglect, and household dysfunction during childhood are at increased risk of developing chronic illnesses including heart disease, cancer, and chronic emphysema. A relationship between early childhood adversity and health risk factors contributing to chronic disease such as smoking, obesity, and sedentary lifestyle has also been established in prior literature. Chronic conditions carry many negative consequences at both societal and individual levels and have been associated with significant financial cost, a decline in quality of life, and functional impairment. According to research, more than half of an average community sample has experienced at least one type of adverse childhood experience, including psychological, physical, or sexual abuse or substance abuse, mental illness, domestic violence, or criminal behavior within the household, with approximately 25% experiencing two or more. However, there is evidence that higher than usual levels of trauma exist in forensic inpatient samples, which may increase the odds of chronic disease development in this population. Despite this evidence, little research exists examining the prevalence of adverse childhood experiences in forensic mental health clients, as well as the relationship between trauma and chronic health conditions and risky health behaviors in this population. Archival data were collected from a forensic psychiatric facility in the Midwestern US. Inclusion criteria included admission since 2005, residence for at least one year, and discharge prior to data collection. A list of clients (N=182) meeting inclusion criteria was randomly generated by the facility’s research coordinator. Medical, psychiatric, social services, and annual review reports as well as discharge summaries were coded by three trained research assistants. The sample was predominantly male (N=147; 80.8%) and Caucasian (N=101; 55.5%). The average admission age was 32.5 years (SD=11.6 years) and average discharge age was 40.5 years (SD=12.7). Reasons for initial admission include transfers from lower-security facilities for aggressive behavior, lack of competency to stand trial, direct admission from the state department of corrections, suicidality or self-harm behavior, and pretrial evaluation. All participants were civilly committed to the facility at the time of discharge. In this study, frequencies and descriptive statistics will illustrate the prevalence of adverse childhood experiences broadly and categorically within a forensic inpatient facility. Logistic regression will also be used to examine the relationship between adverse childhood experience and later chronic disease diagnosis. A hierarchical regression will also be used to evaluate to what extent risky health behaviors account for relationships between chronic diseases and adverse childhood exposures. Results may explain how trauma exposure may increase the likelihood of chronic illness among forensic mental health patients.

Early adverse experiences in childhood (e.g., abuse, neglect, and household dysfunction) have been linked to negative long-term effects on physical and mental health. Kaiser Permanente and the CDC surveyed adults in the community in the mid-1990s and found a strong and cumulative relationship between the degree of exposure to adverse childhood experiences (ACEs) and risk factors for negative outcomes in adulthood including higher risk for substance abuse and intimate partner violence. Also, criminal populations, particularly sexual offenders, report much higher rates of adversities than the general public. College students have a disproportionately high risk of intimate partner violence, rape, and other forms of sexual assault, and there is limited research on the characteristics of perpetrators and victims of sexual and intimate partner violence on campus, which could inform prevention efforts and our understanding of repeated victimization and the effects of cumulative experiences of victimization. Our sample consists of university students (N = 995; 69.2% female; M = 20 years old) who are predominantly Caucasian (84%) in the Southeastern US. An ACE total score between 0 and 10 was calculated for each participant by summing the number of Yes responses indicating experiences of childhood adversities. Regarding the prevalence of childhood adversities, 71% of the sample experienced at least one, and approximately 19% fell within the “high-risk” range of 4 or more ACEs, which is higher than the 13% of adults from the community who reported 4 or more ACEs in the original study conducted by the CDC. Thus, it appears that childhood adversities are widespread among college students in this sample. Regarding outcomes since turning 18 years of age, 2% of the sample admitted to engaging in coercive sexual behavior, 1% admitted to having sexual contact with someone who was not fully consenting, 1% had been arrested for a sexual offense, and 0.1% reported being a registered sexual offender. These behaviors were collectively considered sexual misconduct for the purpose of analyses. A logistic regression analysis yielded a significant model ( 2 = 29.51, R 2 = 0.11, p = 0.000) and indicates ACE Total Score (β = 0.34,  2 = 26.73, p = .00) and gender (β = - .85,  2 = 5.80, p = .02) predict sexual misconduct in adulthood. A second logistic regression analysis significantly predicted physical violence towards a partner as an adult ( 2 = 55.52, R 2 = 0.13, p = 0.000) Page 122 2016 Appalachian Student Research Forum with significant effects from ACE total score (β = 0.32,  2 = 42.41, p = .000) and gender (β = 1.16,  2 = 11.62, p = .001). Our findings thus far support further investigation of how adverse experiences relate to violent or sexual perpetration among college students. Additional analyses will include the relationships between these outcomes involving perpetration in adulthood and different types of early experiences of adversity, length of victimization and substance abuse.

Childhood Sexual Abuse (CSA), along with other Adverse Childhood Experiences (ACES), has been linked to a range of adverse health outcomes among adults. However, there is paucity of research specifically studying CSA and sexual risk behaviors among adolescents. Even less is known for the population in Appalachia. The few researchers who study this topic have mostly focused on females or have failed to use advanced statistical techniques to generate evidence on causality. This research was undertaken to investigate the association between CSA and sexual risk behaviors of college students in Appalachia. College students enrolled in introductory psychology classes in the Appalachian region were administered an online questionnaire on CSA, ACES, and current sexual behaviors in 2015. Simple and multivariate logistic regressions were completed for CSA to predict illegal drug use before sex, use of condom during sex, and perceived risk of HIV. Age, gender, and other ACEs (physical, emotional, verbal abuse, substance abuse in family, family mental illness, and family incarceration) were considered as covariates. Only statistically significant covariates were included in the final model. All analyses were completed using STATA. Of the total 982 adolescents, 67% were female. The average age of the participants was 20 years. In the unadjusted model, CSA was significantly associated with illegal drug use before sex (OR 2.32, CI 1.46 - 3.68) and perceived risk of HIV (OR 2.19, CI 1.39 - 3.46). The association between CSA and illegal drug use before sex (OR 1.67, CI 1.03 - 2.73) was significant in the final model too. Further, based on the final model, CSA increased the odds of perceiving oneself at risk of HIV by 1.9 times (CI 1.19 - 3.03). Verbal abuse was also found to be significantly associated with illegal drug use before sex (OR 2.22, CI 1.55 - 3.19) and perceived risk of HIV (OR 1.8, CI 1.26 - 2.57). However, neither CSA (OR 1.02, CI 0.55 - 1.89) nor other covariates was associated with condom use among these adolescents. It is a noteworthy result and suggests the need of further investigation of the factors related to condom use among adolescents in order to understand the peculiar nature of this behavior. Finally, CSA was found to increase the odds of some risky sexual behaviors among college students in Appalachia. Consideration of this relationship can enrich the knowledge base required to design effective interventions targeted at sexual behaviors of adolescents. Additionally, further exploration can be useful to enhance the understanding of effects of other ACES like verbal abuse on sexual risk behaviors, and predictors of condom use among adolescents.

Exposure to abuse, neglect, and familial dysfunction in childhood is connected to long-term negative effects on mental and physical health in adulthood. Current research of adverse childhood experience is overwhelmingly focused on community samples. Those populations that tend to experience a greater number of adversities (e.g., high-risk forensic populations) are largely overlooked. Studies investigating differential risk factors and outcomes among those in high-risk populations could indicate environmental 2015 Appalachian Student Research Forum Page 107 responsiveness to experiences of abuse, neglect, and household dysfunction in early development. A pilot study was conducted to investigate the prevalence and severity of childhood trauma, maltreatment, and familial dysfunction using the Adverse Childhood Experience (ACE) survey in a sample of forensic mental health offenders. Participants were randomly selected forensic inpatients (n = 185) from a maximum- and intermediate-security psychiatric facility. The sample is predominantly male (81.0%) and majority Caucasian (56.0%), African American (40.0%), and Hispanic (2.0%) with a mean age of 42.5 (SD=13.2). Approximately 29.0% of the current forensic sample has experienced 4 or more adversities in childhood (e.g., intrafamilial sexual abuse). This is a significantly higher percentage compared to the Center for Disease Control community norms of 12.5% indicating that a greater number of childhood adversities were experienced by the current sample of forensic mental health inpatients than in the general population. Additionally, significant percentages of diagnosed mental health disorders have been revealed. Diagnosed mental disorders in the current sample include, but are not limited to: psychotic disorders (59.0%), intellectual disability or cognitive developmental disorders (57.3%), mood disorders (45.0%), impulse disorders (22.2%), and post-traumatic stress disorder (13.0%). Comprehension of type, severity, and length of exposure to adversities, environmental responsiveness to abuse, maltreatment and familial dysfunction, and the onset and severity of mental and behavioral health outcomes are needed to better inform treatment, intervention, and rehabilitation of forensic psychiatric inpatient populations.

Adverse Childhood Experiences (ACEs) including experiences of neglect and abuse have been shown to negatively impact the victims’ health outcomes. While the ACE score methodology has been widely accepted as the method for measuring childhood trauma, the severity of the abuse has not been accounted for through research. The aim of this research was to assess the duration and frequency of childhood emotional and physical abuse in addition to prevalence among college aged adults, to bridge this gap in the literature. A modified ACE and health behavior questionnaire was administered online at one university beginning July through December of 2014. A sample of 965 participants aged ≥ 18 were included in this study. Two ACE questions, “did a parent or other adult in the household often or very often swear at you, insult you, put you down, or humiliate you? Or, act in any way that made you afraid that you might be physically hurt?” and “did a parent or other adult in the household often or very often push, grab, slap, or throw something at you? Or ever hit you so hard that you had marks or were injured?” were asked to measure the prevalence of emotional and physical abuse, respectively. Descriptive statistics were completed in SAS for age, race, gender, emotional abuse and physical abuse. Frequencies, proportions and corresponding p-values were reported. The sample distribution included: female (69%), age average 20 years (M = 20.21, SD = 4.07), and white (84.9%). In total 29.01% of the sample reported exposure to childhood emotional or physical abuse and 37.5% reported both experiences. Females reported a higher proportion of emotional abuse and less proportion of physical abuse (27.59% and 12.29%) compared to males (24.50% and 15.44%). However, gender differences were not significant, X2 = 1.01, p>0.05 and X2 = 1.77, p>0.05. Of those reporting abuse, about two thirds of emotional abuse and one third of physical abuse occurred frequently defined as occurring either ‘daily’, ‘at least once a week’ or ‘at least once a month’. Modal frequency was ‘at least once a week’ for both female (30.74%) and male (20.31%). More than half of the abusive experiences (60.3% emotional and 53.9% physical) happened for more than two years. Experiences of childhood emotional and physical abuse are common among this sample of college age adults and the occurrence of one type of abuse is most often accompanied by the occurrence of another. This result is consistent with national research that has been done on adult populations. In cases where abuse occurred for this sample, the experiences were frequent and for an extended period of time. An understanding of the prevalence of childhood physical and emotional abuse among college aged adults and the discussion of its implications should be included in college health and counseling programs. Knowledge of the frequency and duration of abuse is critical in identifying the high risk population and developing personalized and targeted programs addressing their specific needs.

It is widely believed that the median is “usually” between the mean and the mode for skewed unimodal distributions. However, this inequality is not always true, especially with grouped data. Unavailability of complete raw data further necessitates the importance of evaluating this characteristic in grouped data. There is a gap in the current statistical literature on assessing mean–median–mode inequality for grouped data. The study aims to evaluate the relationship between the mean, median, and mode with unimodal grouped data; derive conditions for their inequalities; and present their application.

BACKGROUND: Sleep apnea (SA) is a common sleep disorder among US adults. Associations of SA with alcohol consumption and some chronic diseases have been inconsistent. OBJECTIVES: This study aimed to estimate prevalence of SA and examine its associations with potential factors including alcohol consumption, asthma, diabetes, and hypertension. PATIENTS AND METHODS: This was a cross-sectional study on 823 adults with SA and 38,638 controls from the 2011 National Survey on Drug Use and Health Data. Weighted univariate and multiple logistic regression analyses were used to examine the associations of SA with the potential factors. RESULTS: The prevalence of SA was higher in males (4.01%) than in females (2.61%), while the prevalence increased with age (0.86%, 3.50%, and 4.47% for age groups of 18-25, 26-64, and ≥ 65, respectively). Univariate analysis revealed that all factors except for income and education were associated with SA (P < 0.05). In multivariable analyses, participants who were current and past alcohol consumers had significantly higher odds of having SA (OR = 1.52, 95% CI = 1.03-2.23; OR = 1.65, 95% CI = 1.09-2.49, respectively) than non-alcohol drinker. Furthermore, asthma (OR = 2.77, 95% CI = 2.04-3.75), diabetes (OR = 2.89, 95% CI = 2.19-3.83), and hypertension (OR = 2.42, 95% CI = 1.91-3.07) were significantly associated with SA. CONCLUSIONS: Age, alcohol consumption, asthma, diabetes, and hypertension, were positively associated with SA. More efforts should be directed to promoting screening for SA and finding possible treatments for SA among these vulnerable groups.

OBJECTIVE: Piwi-interacting RNAs (piRNAs) represent a molecular feature shared by all nonaging biological systems, including the germline and somatic cancer stem cells, which display an indefinite renewal capacity and lifespan-stable genomic integrity and are potentially immortal. Here, we tested the hypothesis that piRNA is a critical genetic determinant of aging in humans. METHODS: Expression of transcriptome-wide piRNAs (n=24k) was profiled in the human prefrontal cortex of 12 subjects (84.9±9.5, range 68-100, years of age) using microarray technology. We examined the correlation between these piRNAs' expression levels and age, adjusting for covariates including disease status. RESULTS: A total of 9,453 piRNAs were detected in brain. Including seven intergenic and three intronic piRNAs, ten piRNAs were significantly associated with age after correction for multiple testing (|r|=0.9; 1.9×10≤p≤9.9×10). CONCLUSION: We conclude that piRNAs might play a potential role in determining the years of survival of humans. The underlying mechanisms might involve the suppression of transposable elements (TEs) and expression regulation of aging-associated genes.

Alleles, genotypes and haplotypes (combinations of alleles) have been widely used in gene-disease association studies. More recently, association studies using diplotypes (haplotype pairs on homologous chromosomes) have become increasingly common. This article reviews the rationale of the four types of association analyses and discusses the situations in which diplotype-based analyses are more powerful than the other types of association analyses. Haplotype-based association analyses are more powerful than allele-based association analyses, and diplotype-based association analyses are more powerful than genotype-based analyses. In circumstances where there are no interaction effects between markers and where the criteria for Hardy-Weinberg Equilibrium (HWE) are met, the larger sample size and smaller degrees of freedom of allele-based and haplotype-based association analyses make them more powerful than genotype-based and diplotype-based association analyses, respectively. However, under certain circumstances diplotype-based analyses are more powerful than haplotype-based analysis.