Research examining Adverse Childhood Experiences (ACEs) has mostly focused on the long-term effects of these experiences on adult mental and physical health. Less attention has been focused on the impact of ACEs on college student satisfaction, dropout rates, and major choice. The overarching questions for the current study sought to further research by (1) assessing if there is a relationship between the ACE scores of college students and their mental and physical health, (2) if ACEs play a role in student satisfaction or desire to drop out, and (3) determining if there is a connection between students with high ACE scores and their major choice. Survey data was collected from a sample of East Tennessee State University students. Findings serve to improve our understanding of the topic and promote research for the future.

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Childhood trauma greatly impacts the lives of patients and their future health outcomes. Since the discovery of the utility of the Adverse Childhood Experiences (ACEs) screening tool in the 1990s, many providers have attempted to screen and intervene on these past experiences of trauma with mixed results. ACEs have an outsized impact on adult health. There is considerable literature documenting the changing state of screening for ACEs in adult populations, and the compelling rationales for doing so. There are also a number of interventions available currently, but providers face challenges to use them. Ethical considerations and issues with the current state of screening for ACEs exist, due to some of these challenges and differential availability of interventions between populations. Here, I use the principles of urban bioethics to explain the ethical obligation of screening for ACEs despite these challenges and to dispute previous discussions on this topic. This article will show that there are general strategies that providers can take to implement ACEs screening in an ethical manner and specifically discusses trauma-informed care’s utility to help achieve these strategies. Through this discussion, I hope to encourage providers to reconsider ACEs screening and give them strategies to do so. / Urban Bioethics

Maternal adverse childhood experiences (ACEs) are associated with difficulties in parent- child relationships, however, research to date has focused on cross-sectional associations. Parent and child behavior may be differently affected by ACEs as a child develops and caregiving demands change. Furthermore, poorer executive function (EF) is associated with both ACEs and problematic parenting processes, and may be one potential mechanism involved in the intergenerational transmission of ACEs. This study examined longitudinal associations between maternal ACEs, maternal EF, and patterns of change in maternal and child emotional availability (EA) using longitudinal multilevel modelling (MLM). Mother-child dyads (N = 114) were followed at five separate assessments over a 5-year period. Maternal ACEs were measured retrospectively at 3-months postpartum, maternal EF was assessed at 8-months, and mother-child interactions were videotaped at 18-, 36- and 60-months postpartum. Results revealed that maternal EA was stable, while child EA increased from 18- to 60-months postpartum. Maternal ACEs were negatively associated with maternal and child EA at 18-months postpartum and this effect decreased overtime. In contrast, there was a persistent, positive effect of maternal EF on EA trajectories. Maternal EF did not mediate the association between ACEs and EA. Findings also demonstrated significant within-dyad associations between maternal and child EA. These findings lead to a deeper understanding of the effects of maternal influences on parent-child relationships. We provide important evidence regarding the intergenerational transmission of ACEs, demonstrating that effects of maternal ACEs on parenting are not necessarily persistent. Findings also support sustained relations between maternal EF and maternal and child behavior across development, suggesting the utility of EF as an intervention target. / Thesis / Master of Science (MSc) / Adverse childhood experiences (ACEs), which are experiences of abuse, neglect, and household dysfunction, are risk factors for difficulties in parent-child relationships when individuals become parents themselves. In addition, ACEs are associated with deficits in higher-order cognitive abilities called executive functions (EF) in adulthood, which may also, in turn, compromise an individual’s ability to provide sensitive and nurturing care to their children. The following thesis explores the collective relationships between maternal ACEs, maternal EF, and emotional availability during parent-child interactions in a community sample of mothers and their children, followed from toddlerhood (18-months postpartum) to preschool (60-months postpartum). Findings from this study demonstrate unique trajectories of maternal and child emotional availability during this period in development. Higher maternal ACEs were associated with decreased emotional availability during parent-child interactions at 18-months postpartum and this effect decreased overtime. Mothers with higher EF, and their children, demonstrated increased emotional availability across development. Maternal ACEs was not associated with maternal EF. Findings are relevant in informing the development and adaptation of timely and preventative parenting interventions.

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Despite evidence to suggest that pathways from adverse childhood experiences (ACEs) to psychological distress and offending are gender-specific, theory-driven research examining intervening factors in such pathways is rare. Utilising a mixed-method design, the research presented in this thesis aimed to a) provide further insight into gender-specific trajectories from ACEs to negative outcomes and b) to identify a theoretically viable framework within which to conduct such research. It was anticipated that comparing and contrasting the quantitative (Study 1 and Study 2) with the qualitative (Study 3) findings would help to inform interventions to reduce female offending. The literature review identified an attachment framework as appropriate for the research and highlighted a range of factors that warranted investigation. The findings from an internet survey (Study 1) in a mixed-gender community sample provided some support for the notion of genderspecific pathways to offending. Moreover, several variables were identified (e.g. emotional intelligence, empathy and anger) that warranted further examination in a second survey (Study 2) with a sample of women with a history of ACEs (ex- and non-offenders). The findings from the two studies suggested that emotion coping and management (EI) skills may foster resilience to negative experiences and also provided support for the use of an attachment framework in research that examines the negative sequelae of ACEs. The qualitative study (Study 3) utilised interpretative phenomenological analysis in order to gain a deeper insight into women’s trajectories from ACEs to psychological distress and offending. The findings strongly suggested that interventions may need to target deficits in emotion regulation in order to ameliorate the potential negative outcomes of chronic childhood adversity. The importance of context was also highlighted. Additionally, EI and an emotional approach to coping were identified as factors that were beneficial in terms of the women’s psychological well-being. The findings from the research highlighted emotion coping and management skills as useful targets for intervention in women ex-offender populations with a history of ACEs and associated psychological distress. Based on the findings reported in this thesis, recommendations were made with regard to future research in the field of ACEs, psychological distress and offending.

Individuals exposed adverse childhood experiences (ACEs) are at increased risk of developing chronic illnesses in adulthood including heart disease, cancer, diabetes, and chronic pain. A relationship between ACEs and health risk factors contributing to chronic disease such as smoking, obesity, and sedentary lifestyle has also been established in prior literature. There is evidence that higher that individuals in forensic inpatient mental health samples are disproportionally exposed to ACEs, which may increase odds of chronic disease development. Despite this evidence, little research has examined the prevalence of ACEs and relationships between ACEs and chronic health conditions and risky health behaviors in this population. This study evaluated these variables using archival data collected as part of a large interdisciplinary study from a forensic psychiatric facility. A list of clients (N=182) meeting inclusion criteria was randomly generated and a comprehensive record review was used to ascertain ACE scores and rates of health-risk behaviors and chronic conditions. Findings offered support for increased rates of childhood adversity and a significant relationship between ACE scores and health-risk behaviors within a forensic inpatient mental health population. However, relationships between ACEs and chronic illnesses and health-risk behaviors and chronic illnesses failed to reach significance. The lack of significance in these relationships suggests that ACEs are less singularly predictive of chronic illness within this population and instead different factors may drive the development of chronic illness.

Adverse childhood experiences (ACEs) are events that take place during one’s youth that may be stressful or traumatic (Adverse Childhood Experiences, 2017) and a strong focus within this body of knowledge has been on the experiences of childhood neglect and abuse. Emerging adulthood is a distinct developmental phase of the life course characterized by extensive self-exploration and consideration about the future (Arnett, 2000). Given that identity exploration continues to be important during emerging adulthood, it is important to study ACEs and the effects they have on the emerging adult who is making decisions regarding their future. Much of the literature on ACEs has been dedicated to establishing the relationship between ACEs and negative health outcomes. For instance, research has shown that ACEs have been linked to increased risks for suicide attempt and ideation throughout one’s lifespan (Sachs-Ericsson et. al, 2016) and has also been associated with feelings of anxiety (Briggs & Price, 2009), guilt (Kaess et. al, 2013), and depression (Briggs & Price, 2009). Therefore, ACEs and negative health outcomes have already been strongly confirmed. The positive psychology movement (Seligman & Csikszentmihalyi, 2014) has brought to scholars’ attention the need to expand on conceptualizations of what it means to be doing well. Specifically, it is no longer sufficient to define optimal well-being only in terms of the absence of negative outcomes. In order to assess holistic well-being, consideration must also be given to positive factors. A recent review of the literature yielded no studies that have explored the presence, or absence, of positive well-being factors in conjunction to negative health outcomes among those having experienced ACEs. In order to obtain a true understanding of holistic well-being at critical developmental junctures, the current study moves beyond a sole focus on pathology by also considering how life satisfaction and subjective happiness manifest during emerging adulthood in relation to ACEs. Data on 284 participants were collected and analysis is forthcoming. Participants were recruited through the use of physical flyer postings, social media advertisements, and through Amazon’s Mechanical Turk (mTurk) system. Regression analysis and bivariate assessments will be used to explore the relationship between ACEs and depression, anxiety, life satisfaction, subjective happiness, and survivor’s guilt. Findings will be discussed in terms of broadening our understanding of the impacts to holistic well being for as related to ACEs during a rather critical and busy developmental juncture, emerging adulthood. Moving beyond pathology-focused models will expand on professional practice by utilizing frameworks embedded within a strengths-based approach. Educators, advocates, practitioners, and clinicians can utilize this this knowledge to enhance their work with clients and the services provided.

This study sought to examine the relationship between adverse childhood experiences and intimate partner violence in adult committed, monogamous, same sex female relationships. Participants included lesbian or queer cisgender women, age 18 or over, who were in a current committed relationship of at least six months. Partnerships with local and national lesbian advocacy groups allowed electronic access to participants. A total of 87 participants completed the Adverse Childhood Experiences Questionnaire and the Abusive Behaviors Inventory. All participants were anonymous. The three examined variables included emotional/psychological abuse, sexual abuse, and physical abuse. These variables were entered into the Software Program for Statistical Analysis (SPSS) using correlational matrices, hierarchical regression, and one-way ANOVA analyses. Results from the data analysis will provide insight into the relationship of each variable on the presence of intimate partner violence in adult committed, monogamous, lesbian or queer cisgender relationships.

Adverse birth outcomes and adverse childhood experiences (ACE) are concerns in the United States, with potential to impact health indices now and in the future. The purpose of this study was to quantitatively examine the association between maternal exposure to ACE, low birth weight, and county of residence in the Appalachian population using the Life Course Approach as the theoretical framework. A cross-sectional study design and clustering strategy was used to randomly select potential respondents from a data set that was provided by Ohio Department of Health. Self-administered questionnaires were sent to potential respondents to collect information about ACE in the maternal population of Appalachia, Ohio with an overall response rate of 29.5% and 212 total participants. A chi-square analysis was completed and no significant association was found between county of residence and risk of low birth weight. However, statistically significant associations were found between the different types of ACE exposure and low birth weight delivery as well as Appalachian county of residence and exposure to ACE. As the sample of low birth weight deliveries was small, it is recommended that the relationship between ACE exposure and low birth weight be further studied to develop more purposeful health interventions to improve maternal health in Appalachia, Ohio specifically, as well as other rural communities. Reducing rates of adverse birth outcomes and chronic disease burden in Appalachia have potential to reduce health disparities between urban and Appalachian communities, allowing for positive social change for many socioeconomically disadvantaged communities and improving population health.