Adverse childhood experiences (ACEs) are concerning exposures that may have detrimental effects on mental health. Much of the prior evidence on ACEs comes from the U.S and western developed ...countries. In light of the limited knowledge of ACEs in other social contexts and the interconnection among adversities, this study aims to identify distinct patterns of co-occurring ACEs and examines the associations between those adversities and mental health in South Korea. We used data from a national sample of Korean college students recruited via non-probability quota sampling in 2019 (N = 1037). The dependent variables included three measures of mental health assessed by the Brief Symptom Inventory depression symptoms, anxiety symptoms, and somatization symptoms. The independent variable was the patterns of ACEs identified using 14 indicators of childhood adversity. We conducted a Latent Class Analysis with a distal outcome, using the Bolck, Croons, and Hagenaars method. The analysis found four patterns of ACEs: extreme adversity (8%), family violence (20.3%), economic adversity (10.4%), and low adversity (61.3%). The extreme adversity group exhibited multiple exposures, including interpersonal violence in home environments, economic hardship, and bullying victimization by peers. The results suggest that the extreme adversity and family violence groups showed significantly worse mental health symptoms than the economic adversity and low adversity groups. Also, the extreme adversity group reported significantly higher levels of depression symptoms and somatization symptoms than the family violence group. This study expands the current understanding of ACEs and their harmful effects on mental health in young adulthood specific to Korea while comparing them with other social contexts. Researchers and practitioners should recognize the co-occurrence of child adversities, rather than overestimating sole adversity, to develop effective strategies for promoting mental health.
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NUK, OILJ, SAZU, UKNU, UL, UM, UPUK, VSZLJ
Increasing amounts of time using digital media (i.e., texting, social media, electronic gaming, and general smartphone and computer use) among children and adolescents is becoming a growing concern ...given its potentially deleterious effects on health. However, little is known about the social and developmental underpinnings of digital media use among children and youth. This study examines the link between adverse childhood experiences and digital media use among a recent, nationally representative sample of children and adolescents.
Data pertaining to children/youth aged 6–17 years from the 2018 National Survey of Children's Health were analyzed in 2020 (N=21,954). The association between 9 distinct forms of childhood adversity and time spent on digital media among youth was assessed using multinomial logistic regression. The mediating roles of family-, parent-, and child-level factors were determined using the Karlson–Holm–Breen method.
Net of covariates, the relative risk of heavy digital media use was 3 times higher among youth experiencing ≥4 adverse childhood experiences than among those experiencing none. Both family resilience and connection as well as parenting stress emerged as significant mediators of the association between adverse childhood experiences and heavy digital media use, collectively accounting for approximately 39% of the association.
In an effort to mitigate heavy digital media use, providers and practitioners who consistently interact with youth should consider screening for adverse childhood experiences and referring high-risk youth and their families for various prevention and treatment programs poised to address these risk factors.
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GEOZS, IJS, IMTLJ, KILJ, KISLJ, NLZOH, NUK, OILJ, PNG, SAZU, SBCE, SBJE, UILJ, UL, UM, UPCLJ, UPUK, ZAGLJ, ZRSKP
We leveraged nationally representative data from the Panel study of Income Dynamics-Child Development Supplement (N = 3,562) and the Early Childhood Longitudinal study (N = 18,174), to chart the ...development of working memory, indexed via verbal forward and backward digit span task performance, from 3 to 19 years of age. Results revealed nonlinear growth patterns for forward and backward digit span tasks, with the most rapid growth occurring during childhood followed by a brief accelerated period of growth during early adolescence. We also found similar developmental trajectories on digit span task performance for males and females across the U.S. population. Together, this study highlights the relative importance of the childhood period for working memory development and provides researchers with a reference against which to compare the developmental changes of working memory in individual studies. From a practical perspective, clinicians and educators can also use this information to understand important periods of working memory growth using national developmental trends.
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CEKLJ, FFLJ, NUK, ODKLJ, PEFLJ, UPUK
Curiosity, the desire to learn new information, has a powerful effect on children's learning. Parental interactions facilitate curiosity-driven behaviors in young children, such as self-exploration ...and question-asking, at a certain time. Furthermore, parenting quality predicts better academic outcomes. However, it is still unknown whether persistent parenting quality is related to children's trait epistemic curiosity (EC). The current study examined whether parenting practices, responsiveness, and demandingness are cross-sectionally related to the trait EC of children in different age groups (preschoolers, younger and older school-aged children). We adopted a shortened Japanese version of the parenting style questionnaire and modified the trait EC questionnaire in young children. A sample of 244 caregivers (87.37% mothers) of children (ages 3-12) was recruited through educational institutions in Japan and reported on their parenting practices and trait EC. All data analyses were performed using SPSS version 26. Hierarchical regression analyses were performed to determine the explanatory variables for children's trait EC. Self-reported parental responsiveness significantly explained EC scores. To the best of our knowledge, this is the first study to show a cross-sectional relationship between parental responsiveness and children's trait EC. Future research should clarify whether parental responsiveness in early childhood predicts children's EC later in life.
Adverse childhood experiences (ACEs) are related to a host of deleterious physical and mental health outcomes. The ACE–International Questionnaire (ACE-IQ) was developed to assess categories of ACEs ...(e.g., sexual, emotional, and physical abuse) in internationally representative samples. Though the ACE-IQ has been used world-wide, little work has examined the structure of this measure. Further, much of the modeling techniques implemented lacked theoretical rationale. The present work used two principal components analyses (PCA) to evaluate the ACE-IQ structure using both the identified ACE categories as defined by the World Health Organization (WHO) and using the ACE-IQ items as individual indicators. Using the WHO method, a two-component structure was indicated. Alternatively, a PCA of the individual items yielded a six-component structure. Results highlight the importance of theoretically grounded measure evaluation and the potential distinctions amongst types of ACEs. Implications and future directions for research and practice are discussed.
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NUK, OILJ, SAZU, UKNU, UL, UM, UPUK
Current therapies for medulloblastoma, a highly malignant childhood brain tumour, impose debilitating effects on the developing child, and highlight the need for molecularly targeted treatments with ...reduced toxicity. Previous studies have been unable to identify the full spectrum of driver genes and molecular processes that operate in medulloblastoma subgroups. Here we analyse the somatic landscape across 491 sequenced medulloblastoma samples and the molecular heterogeneity among 1,256 epigenetically analysed cases, and identify subgroup-specific driver alterations that include previously undiscovered actionable targets. Driver mutations were confidently assigned to most patients belonging to Group 3 and Group 4 medulloblastoma subgroups, greatly enhancing previous knowledge. New molecular subtypes were differentially enriched for specific driver events, including hotspot in-frame insertions that target KBTBD4 and 'enhancer hijacking' events that activate PRDM6. Thus, the application of integrative genomics to an extensive cohort of clinical samples derived from a single childhood cancer entity revealed a series of cancer genes and biologically relevant subtype diversity that represent attractive therapeutic targets for the treatment of patients with medulloblastoma.
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IJS, KISLJ, NUK, SBMB, UL, UM, UPUK
Spinal muscular atrophy type 1 is a motor neuron disorder resulting in death or the need for permanent ventilation by age 2 years. We aimed to evaluate the safety and efficacy of onasemnogene ...abeparvovec (previously known as AVXS-101), a gene therapy delivering the survival motor neuron gene (SMN), in symptomatic patients (identified through clinical examination) with infantile-onset spinal muscular atrophy.
STR1VE was an open-label, single-arm, single-dose, phase 3 trial done at 12 hospitals and universities in the USA. Eligible patients had to be younger than 6 months and have spinal muscular atrophy with biallelic SMN1 mutations (deletion or point mutations) and one or two copies of SMN2. Patients received a one-time intravenous infusion of onasemnogene abeparvovec (1·1 × 1014 vector genomes per kg) for 30–60 min. During the outpatient follow-up, patients were assessed once per week, beginning at day 7 post-infusion for 4 weeks and then once per month until the end of the study (age 18 months or early termination). Coprimary efficacy outcomes were independent sitting for 30 s or longer (Bayley-III item 26) at the 18 month of age study visit and survival (absence of death or permanent ventilation) at age 14 months. Safety was assessed through evaluation of adverse events, concomitant medication usage, physical examinations, vital sign assessments, cardiac assessments, and laboratory evaluation. Primary efficacy endpoints for the intention-to-treat population were compared with untreated infants aged 6 months or younger (n=23) with spinal muscular atrophy type 1 (biallelic deletion of SMN1 and two copies of SMN2) from the Pediatric Neuromuscular Clinical Research (PNCR) dataset. This trial is registered with ClinicalTrials.gov, NCT03306277 (completed).
From Oct 24, 2017, to Nov 12, 2019, 22 patients with spinal muscular atrophy type 1 were eligible and received onasemnogene abeparvovec. 13 (59%, 97·5% CI 36–100) of 22 patients achieved functional independent sitting for 30 s or longer at the 18 month of age study visit (vs 0 of 23 patients in the untreated PNCR cohort; p<0·0001). 20 patients (91%, 79–100) survived free from permanent ventilation at age 14 months (vs 6 26%, 8–44; p<0·0001 in the untreated PNCR cohort). All patients who received onasemnogene abeparvovec had at least one adverse event (most common was pyrexia). The most frequently reported serious adverse events were bronchiolitis, pneumonia, respiratory distress, and respiratory syncytial virus bronchiolitis. Three serious adverse events were related or possibly related to the treatment (two patients had elevated hepatic aminotransferases, and one had hydrocephalus).
Results from this multicentre trial build on findings from the phase 1 START study by showing safety and efficacy of commercial grade onasemnogene abeparvovec. Onasemnogene abeparvovec showed statistical superiority and clinically meaningful responses when compared with observations from the PNCR natural history cohort. The favourable benefit–risk profile shown in this study supports the use of onasemnogene abeparvovec for treatment of symptomatic patients with genetic or clinical characteristics predictive of infantile-onset spinal muscular atrophy type 1.
Novartis Gene Therapies.
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GEOZS, IJS, IMTLJ, KILJ, KISLJ, NLZOH, NUK, OILJ, PNG, SAZU, SBCE, SBJE, UILJ, UL, UM, UPCLJ, UPUK, ZAGLJ, ZRSKP
To explore the relationship between adverse childhood experiences and falls in older adults, and the mediating effects of depression on such associations.
This is a prospective study used survey data ...from the China Health and Retirement Longitudinal Study. Twelve expanded ACEs obtained from the 2014 Life History Survey. Depression levels were assessed using the Centre for Epidemiologic Studies Depression Scale-10. Self-reported outcomes of falling evaluated based on “Have you fallen down since the last survey?” and “How many times have you fallen down seriously enough to need medical treatment?” Logistic regression models were used to explore the relationship between ACEs with falls and recurrent falls. Poisson regression models were used to explore the relationship between ACEs and number of severe falls. Besides, mediation analysis was used to explore whether depression mediates the relationship between ACEs and falls in older adults.
The more adverse childhood experiences experienced, the higher the risk of fall and recurrent falls, and the more severe the falls. Additionally, depression partially mediated the relationship between adverse childhood experiences and falls. Besides, middle-aged individuals were more susceptible to the impact of adverse childhood experiences on falls than older individuals, especially males.
Exposure to adverse childhood experiences is associated with falls in older adults, and depression partially mediates this association. Middle-aged adults were more susceptible to the impact of adverse childhood experiences on falls. These offer important information for clinical practice and public health interventions to prevent falls and reduce fall-related injuries among older adults.
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•Are ACEs associated with falls in older adults and does depression mediate such an association?•Exposure to more ACEs was associated with higher risk of falls, recurrent falls, and more severe falls.•Depression partially mediated the effect of ACEs on falls.•Middle-aged adults were more susceptible to the impact of ACEs on falls than older adults.
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GEOZS, IJS, IMTLJ, KILJ, KISLJ, NLZOH, NUK, OILJ, PNG, SAZU, SBCE, SBJE, UILJ, UL, UM, UPCLJ, UPUK, ZAGLJ, ZRSKP
Childhood adversity (CA) is associated with increased risk of psychopathology, and reward processing (RP) may be one of the underlying mechanisms. However, evidence on impaired RP in childhood ...adversity is theoretically and methodologically heterogeneous.
To provide a quantitative overview of studies on the relation between childhood adversity and RP assessed at the behavioral and subjective levels, and identify differences between studies that influence the effect size.
Twenty-seven studies (overall N = 6801) were included.
Peer-reviewed publications describing empirical studies on the relation between CA and behavioral and self-report measures of RP in humans were identified through systematic searches in six bibliographic databases. Effect sizes (r) were pooled using random-effects models. The potential moderator role of RP dimension, type of RP assessment, type of childhood adversity assessment, and age were examined.
Results indicated a small, but consistent association between CA and impaired RP (r = 0.12; 95% CI: 0.07, 0.16), with medium heterogeneity (I2 = 62.43). The effect size was significantly larger (i.e., medium-sized) in studies that focused on reward learning rather than reward valuation and reward responsiveness; used cognitive tasks rather than self-report assessments of RP; and relied on official records rather than subjective reports of CA. There was evidence of publication bias, but overall effect size remained significant after imputation.
These results suggest that multidimensional RP impairments (e.g., deficits in reward learning, biased reward valuation) are a consistent marker of CA, and may represent mechanisms underlying the increased risk of psychopathology.
•Consistent association between childhood adversity and impaired reward processing.•The effect size is larger (medium) for reward learning.•Effect size is also larger for task measures of reward processing.•Official records of CA are associated with a larger effect size.
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GEOZS, IJS, IMTLJ, KILJ, KISLJ, NLZOH, NUK, OILJ, PNG, SAZU, SBCE, SBJE, UILJ, UL, UM, UPCLJ, UPUK, ZAGLJ, ZRSKP
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