Search Results (506)

Background/Objectives: The study of adverse childhood experiences (ACEs) has become increasingly important due to its impact on the physical and mental health throughout life. The aim of this study is to assess the psychometric quality of the instruments used to measure ACEs, following the COSMIN guidelines for reviewing patient-reported outcome measures. Methods: A PRISMA-adherent systematic search of scientific databases was conducted to identify empirical studies analysing the psychometric properties of ACE questionnaires used with children, adolescents, and adults. Ultimately, 20 studies were included, covering various instruments such as the ACE-10, ACE-Q, ACE-SQ, ACE-IQ, SC-ACE-IQ, ACE-IQ-10 and the ACE-THL. Results: The results show heterogeneous psychometric evidence. Whilst properties such as internal consistency generally show adequate results, other dimensions, such as responsiveness or measurement error, are scarcely evaluated. Furthermore, methodological limitations were identified, such as the predominant use of young female samples and the lack of longitudinal studies. Conclusions: In conclusion, most available ACE instruments demonstrate good psychometric properties, with the ACE-IQ being the one with the strongest evidence supporting these properties across different contexts. Full article

Adverse childhood experiences are associated with long-term metabolic disturbances, yet their effects on the exocrine pancreas remain poorly understood. Using maternal separation (MS) as a model of early-life stress, this study examined whether MS modifies the exocrine pancreatic response to a post-weaning high-fat diet (HFD) in male C57BL/6 mice. Animals were exposed to MS or standard rearing conditions and fed a control diet or HFD for 16 weeks. Body and pancreatic mass, plasma amylase and lipase activities, exocrine pancreatic histopathology, and apoptosis were assessed. HFD increased body mass and reduced the pancreas-to-body mass ratio independently of MS, without altering absolute pancreatic mass. Lipase activity increased significantly in response to both MS and HFD, whereas amylase showed a non-significant upward trend. Histopathological analysis revealed condition-dependent exocrine pancreatic remodeling, including acinar hypertrophy, autophagic vacuolization, focal necrosis, vascular alterations, interstitial edema, and ductal changes. These alterations were mild in HFD-only mice but more pronounced in MS-exposed animals, particularly when combined with HFD. Apoptosis was strongly influenced by early-life stress and modulated by diet, with significant effects of MS and the MS × diet interaction. Overall, early-life stress induces persistent structural and functional alterations in the exocrine pancreas, increasing susceptibility to nutritional challenges in adulthood. Full article

Background/Objectives: Adverse childhood experiences (ACEs) are associated with child socio-emotional difficulties, but when using parents’ reports, it remains unclear which scoring approaches are most informative about younger children. This study evaluated a Portuguese caregiver-report ACE assessment derived from the Finkelhor/Turner framework in a community sample of children aged 2–10 years. Methods: Caregivers provided reports on ACE exposure and socio-emotional adjustment for 341 children. Three ACE scores were compared: an approximate original ACE score, a full ACE pool score, and an adapted reduced caregiver-report score. Associations with socio-emotional adjustment were examined using correlations, adjusted regressions, ROC analyses, domain models, and latent class analysis. Results: Higher ACE exposure was associated with greater difficulties and lower prosocial behavior. The nine-item approximate original ACE score, which did not include emotional neglect, showed the strongest overall predictive and discriminative performance for caregiver-reported SDQ outcomes in this Portuguese sample. This finding should therefore be interpreted as evidence regarding the available approximation of conventional ACE indicators rather than the complete original ACE inventory. Among the two expanded ACE scoring approaches, however, the adapted reduced score consistently outperformed the full ACE pool, supporting a more parsimonious approach. ROC analyses indicated acceptable discrimination for elevated total difficulties, with the approximate original score showing the highest area under the curve (AUC); however, positive predictive values were low across all three scores, indicating limited stand-alone screening utility at the individual level. Domain analyses highlighted economic stressors, maltreatment, and family disorder as salient predictors. Latent class analysis identified low adversity, moderate family/economic adversity, and high polyadversity profiles. Both adversity-exposed classes showed poorer socio-emotional adjustment than the low-adversity class. Conclusions: Findings support the relevance of caregiver-report ACE assessment for understanding socio-emotional adjustment in young children, while also highlighting the need for developmentally sensitive, culturally adapted, and outcome-validated scoring approaches. More extensive ACE pools were not necessarily more informative than shorter empirically or theoretically grounded scores. Full article

Background. Bipolar disorder (BD) is characterized by circadian rhythm disruptions, contributing to mood instability and recurrence. These rhythms are regulated by clock genes in the suprachiasmatic nucleus, including the CLOCK 3111T/C (rs1801260) polymorphism that has been linked to delayed sleep phase, insomnia, and altered circadian expression. Both circadian disruption and adverse childhood experiences (ACEs) correlate with white matter (WM) abnormalities. We hypothesized that rs1801260 moderates ACE effects on WM microstructure in BD. Methods. We enrolled 137 BD patients in depressive episodes. Participants underwent 3T MRI, rs1801260 genotyping and completed the Childhood Trauma Questionnaire. Moderation (PROCESS) tested genotype–ACE interactions on whole-brain fractional anisotropy (FA), axial diffusivity (AD), mean diffusivity (MD), and radial diffusivity (RD) values; voxel-wise TBSS (FSL Randomize) localized effects, with sex-stratified and GLZ analyses for genotype–sex interactions. Results. Significant rs1801260 × ACE interactions emerged for FA and RD across physical abuse, physical neglect, and emotional neglect. Higher ACEs were associated with lower FA/higher RD only in CLOCK rs1801260*C carriers, mainly females. TBSS showed physical abuse × rs1801260 interaction in the corpus callosum, internal capsule and corona radiata. A GLZ model with separate slopes confirmed physical abuse × sex × rs1801260 interactions on FA/RD, with effects specific to female CLOCK rs1801260*C carriers but genotype-independent in males. Conclusions. rs1801260 moderates the impact of early-life stress on WM integrity in BD, particularly in emotion-regulation tracts, with CLOCK rs1801260*C carriers showing greater vulnerability. Effects are genotype-specific in females but genotype-independent in males, possibly reflecting sex-dimorphic neurodevelopment driven by estrogen–androgen modulation of clock genes, HPA axis, and myelination. Full article

Major depressive disorder (MDD) accounts for a substantial share of global disability-adjusted life years and remains inadequately treated despite pharmacological advances. Growing evidence implicates endocrine-disrupting chemicals (EDCs)—particularly phthalates and bisphenols—as environmental contributors to the onset of these conditions. This narrative review examines evidence from PubMed, Scopus, and Web of Science (January 2000–March 2025) on the relationship between early-life exposure to these compounds and the development of mood disorders, with emphasis on molecular and neurobiological mechanisms. Phthalates such as di(2-ethylhexyl) phthalate (DEHP), and bisphenols such as bisphenol A (BPA), are detected ubiquitously in human urine, blood, placenta, and umbilical cord blood. Key mechanisms identified include Nrf2/HO-1-driven oxidative stress and neuronal apoptosis, disruption of calcium signalling and synaptic plasticity via CREB phosphorylation deficits, epigenetic suppression of brain-derived neurotrophic factor (BDNF) via promoter hypermethylation, NF-κB/NLRP3/IL-1β neuroinflammatory cascades, interference with thyroid hormone bioavailability through transthyretin competition, and PPAR-mediated disruption of brain lipid metabolism. Prenatal and early-life exposure has been associated with ADHD, cognitive impairment, autism spectrum disorder, and elevated risk of depressive and anxiety phenotypes in epidemiological cohorts. Psychological vulnerability factors—perceived stress, deficient emotion regulation, and adverse childhood experiences—likely amplify this biological susceptibility through HPA axis sensitisation. Methodological limitations of current evidence, including reliance on single-spot urine samples and residual confounding, are critically appraised. Future research priorities include longitudinal biomonitoring cohorts, brain organoid mechanistic models, and integration of validated psychiatric assessments into environmental health study designs. Full article

Research has demonstrated the intergenerational effects of parents’ adverse and positive experiences. Despite growth in the literature, previous reviews have primarily focused on the intergenerational effects of parents’ childhood experiences. This scoping review aimed to characterize the intergenerational research on the associations between parental adverse and positive experiences across the life course (including childhood and adulthood) and the developmental, psychological and behavioral outcomes of their offspring. Following a search of ten databases, seven articles met the inclusion criteria. The majority of studies were cross-sectional (n = 4) and published in the United States (n = 6). Female caregivers dominated the data set (84.6%), with the large majority having a sample size above n = 1000. All studies reported a significant association between parent adversity and negative offspring outcomes; however, mixed findings were found for the protective properties of parents’ positive experiences. Findings indicate a need for further exploration, underscoring the importance of adequately powered studies inclusive and diverse in nature. Full article

Background: Children growing up in alcohol-affected families are exposed to chronic stress, adverse childhood experiences (ACEs), emotional insecurity, and environmental instability, all of which may influence neurodevelopmental processes. Numerous EEG markers have been proposed as indicators of attentional regulation, emotional functioning, and stress responsivity; however, their relative diagnostic and practical value remains unclear. The aim of the present study was to verify whether commonly reported EEG markers remain valid indicators of neurofunctional difficulties in children from alcohol-affected families, to establish their hierarchy of importance, and to determine how identified neurofunctional profiles may inform the sequencing of educational interventions and the development of individualized support plans used by educators and social workers. Methods: The study included children aged 6–10 years from alcohol-affected families (n = 20) and a control group from non-dysfunctional family environments (n = 25). Resting-state EEG recordings were conducted under eyes-open and eyes-closed conditions, with analyses focused on the eyes-open condition. Quantitative EEG (qEEG) indices included global, frontal, prefrontal, and midline Theta–Beta Ratio (TBR), frontal alpha asymmetry (FAA), temporal beta stress and parietal beta2 tension. EEG preprocessing was performed using EEGLAB and included artifact rejection, filtering, epoch segmentation, and spectral power analysis. Group differences were analyzed using Welch’s t-tests with Benjamini–Hochberg correction for multiple comparisons. Results: The analyzed EEG markers differed in their ability to distinguish children from alcohol-affected families and controls. The strongest effects were observed for Theta–Beta Ratio (TBR) measures, particularly in frontal and prefrontal regions, indicating impairments in attention regulation, executive functioning, and self-control. Elevated temporal beta stress and parietal beta2 tension reflected increased physiological arousal and chronic stress. In contrast, frontal alpha asymmetry (FAA), commonly associated with depressive emotional processing, was not significant after correction for multiple comparisons. The obtained findings enabled the establishment of a hierarchy of neurofunctional markers, with attentional and executive-function indicators demonstrating greater importance than markers related to depressive symptomatology. Conclusions: The EEG profile of children from alcohol-affected families is characterized primarily by chronic stress, heightened physiological activation, and impaired attention regulation rather than by neurophysiological patterns associated with depression. The results suggest that educational difficulties in this group may stem mainly from deficits in attention control, inhibitory processes, and cognitive flexibility. Consequently, educational interventions should prioritize learning strategies, attentional training, and self-regulated learning skills. The identified hierarchy of EEG markers may also support the development of individualized educational plans and social-support programs, including participation in structured extracurricular activities and interventions aimed at strengthening executive and learning-related competencies. However, given the pilot nature of the present study and the relatively small sample size, these findings should be considered preliminary. Replication in larger, more diverse, and independent cohorts is necessary to confirm the stability, reliability, and generalizability of the identified neurofunctional profile and the proposed hierarchy of qEEG markers before they can be recommended for broader educational and social applications. Full article

Background/Objectives: Sleep health is a multi-faceted biopsychosocial concept that affects well-being across the lifespan. Insufficient sleep occurs in large numbers of children and there is emerging evidence for the influence of socioecological factors and adverse childhood experiences (ACEs). The purpose of this study was to determine the influence of adverse childhood experiences on sleep health in preschool age children as mediated by family interaction habits and outdoor play. Methods: Our secondary analysis of the 2023 National Survey of Children’s Health used the weighted dataset filtered for children ages 3–5 years. Results: Sixty-six percent of parents reported adequate child sleep; nearly 89% of parents reported consistent bedtimes. Seventy-one percent reported no ACEs. Most children had one or more hours of outdoor play each day. Daily family interaction (reading, singing, stories, meals) occurred in approximately half of families. Structural equation modeling results indicated that the negative effects of ACEs on consistent bedtime were mediated by reading aloud and family meals, while adequate sleep duration was mediated by reading aloud and singing/storytelling. Conclusions: These findings represent a promising picture of young children and families, and insight into a window of time during child development when family interaction can positively affect sleep health in spite of adverse childhood experiences. Full article

Many university students have a history of exposure to adverse and potentially traumatic life events and may therefore experience Moral Injury (MI). University students exposed to trauma, and especially relational trauma, should be less impacted if they feel and know with certainty that they are valued and matter to other people. The current study uniquely examined MI distress and its correlates in 382 university students who reported the experience of at least one potentially traumatic event. Additionally, we examined the traumatic experiences faced by a subgroup of 2SLGBTQIA+ students and their associated reactions. Various self-report measures were administered including MI emotions, mattering, anti-mattering, and adverse childhood experiences (ACEs). Our analyses confirmed that MI distress was evident and was linked with ACEs and higher levels of anti-mattering. Main findings accord with the notion that traumatic interpersonal events are not only distressing but are connected with feeling unimportant and insignificant to others. In addition, comparisons with the sexual and gender non-minority subgroups established that 2SLGBTQIA+ students were exposed to higher rates of major life stressors and they had comparatively elevated feelings of not mattering to others and MI-related emotional distress. Collectively, the results underscore the heterogeneity that exists among students and that feelings of mattering versus feelings of not mattering can be a source of strength or vulnerability. Clinical and public health implications are discussed as relevant to addressing feelings of personal insignificance and moral-injury related shame and mistrust. Full article

The healthy development of executive function (EF) skills in childhood and adolescence provides a crucial foundation for later outcomes, from mental and physical health to academic achievement and socio-emotional functioning. Although meta-analyses have identified associations between children’s EF skills and early experiential factors, these are often examined in terms of broad categories (e.g., socioeconomic status) or cumulative risk factors (e.g., adverse childhood experiences; ACEs). The current study leverages longitudinal data (N = 1295) from six cohorts from the Environmental influences on Child Health Outcomes (ECHO) program to identify unique associations among specific prenatal, perinatal, and early life conditions and three specific EF skills (inhibitory control, working memory, and cognitive flexibility) measured later in childhood. Indicators of socioeconomic status, birth outcomes, parental characteristics, and pre- and post-natal exposures to alcohol and tobacco were measured before age 6 years. EF skills and language were measured from ages 6–15 years (M = 9.95, SD = 1.92), using measures from the NIH Toolbox. Two complementary statistical methods, a psychological network approach and regression trees, were employed to disaggregate early predictors of EF development. Results from both methods converged to suggest that specific early conditions showed associations with specific EF skills, and that higher birth weight (independent of pre-term status) was a stronger predictor of better EF skills than other early conditions. Neither approach showed meaningful associations between EF skills and maternal ACEs. Birth weight appears to serve as a particularly sensitive summary index of prenatal influences on EF development. Full article

We present a unifying thesis which posits that the biological resolution of uncertainty is a fundamental adaptation to entropy’s negative impact on the highly ordered molecular structures required to maintain the living state. These molecular biological adaptations are highly conserved and play a critical role in the survival of the earliest multicellular organisms and the vertebrates thereafter. The imperative to reduce cognitive uncertainty is effected through the dopaminergic Medial Forebrain Bundle (MFB) Reward Prediction Error (RPE) mechanism, or its homologous equivalents, to compute a biological valuation of information. This hypothesis is supported by the central role of the MFB seeking system as the neural substrate of exploratory behavior that leads to the reduction of uncertainty when information is apprehended and cognitively assimilated. We define the human experience of intellectual beauty as the subjective emotional reward that is activated by the MFB seeking system. Accordingly, humans experience intellectual beauty when a high-entropy state of confusion is suddenly resolved into a low-entropy state of insight. In humans, the neuroanatomical substrates of inductive reasoning, inquiry, and the intellectual beauty to which they lead are present at birth. What develops postnatally is synaptic plasticity in the connections among these neurons that is activated in the loving didactic relationship that is established between mother and child during infancy. This dynamic is critically dependent on observational learning on the part of the child. It is supported by the joyful engagement and emotional support of the mother. This provides a paradigm of joy in learning that we propose is the developmental origin of intellectual beauty. This is the reinforcement that maintains inquiring behavior in the search for information that is needed to resist the adverse effects of entropy on life. This paper traces the continuous thread of uncertainty resolution from its phylogenetic origins in associative learning to the intuitive science of early childhood, and ultimately to the highest levels of human inquiry in science, as well as literary, musical and visual arts. The intuitive scientific method gives rise to the collective intelligence of groups, an evolved trait that likely contributed to the success of our hominin ancestors. At the societal level, this collective intelligence scales into the institutional working of markets, driving the macroeconomic price discovery of new information to counter entropy. Importantly, we compare the cost of information across the disparate domains of pharmaceutical drug discovery and the contemporary art market to demonstrate that the imperative to reduce uncertainty manifests as a universal, falsifiable mechanism for the “price discovery” of information. Full article

Background/Objectives: Children in early childhood experience higher rates of suspension and expulsion than K–12 students, with persistent racial disparities. Methods: This retrospective descriptive observational study examined exclusionary practices among children ages 0–5 reported by providers participating in a state-level Infant and Early Childhood Mental Health Consultation (IECMHC) initiative within the United States. Results: Providers (n = 689) reported that 3.50% of children were excluded in the 12 months prior to service initiation (1.90% suspended; 1.60% expelled), with higher rates among older children (ages 3–5), males, and Black, Indigenous, People of Color (BIPOC) children. Among a subset of providers of children (n = 395) receiving child-and-family-focused (CFF) consultation, only 28 were expelled (7.09%), with the highest rate observed in children ages 30–36 months. Children expelled during CFF consultation more frequently exhibited atypical protective factors, elevated behavioral concerns, aggression at referral, and higher cumulative adverse childhood experiences (ACEs). Conclusions: Findings suggest that CFF consultation may help mitigate childcare exclusionary practices when children present with severe social-emotional-behavioral challenges. Important considerations for future childcare research and prevention efforts are provided. Full article

Adult mental disorders (aMD), including borderline personality disorder (BPD), major depressive disorder (MDD), and social anxiety disorder (SAD), share adverse childhood experiences (ACEs) as an environmental risk factor. Epigenetic mechanisms, including DNA methylation (DNAm), may mediate the biological link between early adversity and psychiatric risk. SIAH3, implicated in stress-related and mitochondrial pathways, has been previously associated with both ACE and aMD. This study examined SIAH3 DNAm in adults with BPD, MDD, or SAD, relative to healthy control participants (HC), testing effects of diagnosis, ACE exposure, and their interaction across the pooled sample and within each diagnostic group. Both aMD diagnosis and high ACE exposure showed trends toward SIAH3 hypomethylation, and a significant diagnosis × ACE interaction emerged, with inconclusive post-hoc tests. Disorder-specific analyses revealed heterogeneous patterns: in BPD, high ACE showed a trend toward hypermethylation in unadjusted models; in MDD, interaction effects were marginal and not robust to covariate adjustment; in SAD, significant main effects and a diagnosis × ACE interaction were observed, with high ACE associated with lower DNAm exclusively in HC. These findings suggest disorder-specific epigenetic responses to ACE, positioning SIAH3 as a potential molecular link between early life stress, mitochondrial function, and aMD. Full article

Deaf people experience significant barriers to education, healthcare, employment, and information access, resulting in inequities across a myriad of contexts. To better understand these disparities, our all-deaf research team conducted semi-structured interviews with deaf and hearing (parents, caregivers, and educators) adults across Ecuador, exploring how structural, institutional, and social factors influence daily life and well-being. Participants (n = 36) described systemic exclusion from education and employment, limited access to interpreters and assistive technologies, and constrained autonomy due to insufficient family support and institutional resources. These barriers compound health risks by restricting access to care, information, and social participation. Participants’ narratives highlighted how political and economic instability, institutional neglect, and discrimination create structural vulnerabilities that extend beyond individual-level factors. Findings underscore the importance of public health interventions that address structural and communicative inequities, including inclusive education, accessible health services, and community-based support, to improve health equity and quality of life for deaf populations in Ecuador. Full article

Background: Egg allergy is one of the most common food allergies in early childhood and is traditionally managed through strict avoidance diets, which may negatively affect nutrition and quality of life. Early oral immunotherapy (OIT) may represent an alternative therapeutic strategy; however, controlled studies in children younger than two years remain limited. Methods: We conducted a prospective observational study using historical controls. Thirty-one children younger than two years with IgE-mediated egg allergy underwent OIT using pasteurized liquid egg white (maximum dose: 30 mL; 3300 mg protein). Twelve children managed with an avoidance diet served as the historical control group. Outcomes included desensitization rates, adverse reactions, and longitudinal changes in skin prick test (SPT) wheal diameters, serum-specific IgE (sIgE), specific IgG4 (sIgG4), and sIgE/total IgE ratios. Results: At six months, 29/31 children (93.5%) in the OIT group did not experience allergic reactions after ingestion of any egg preparation, compared with none in the historical control group (p < 0.001). In the control group, 7/12 children (58.3%) continued to react to less-cooked egg preparations, whereas 5/12 (41.7%) remained reactive to all forms of eggs. During the induction phase, 24/31 OIT-treated children (77.4%) experienced mild adverse reactions, predominantly isolated cutaneous or gastrointestinal symptoms, and no patient required intramuscular adrenaline administration. In contrast, allergic reactions occurred in 11/12 controls, including anaphylaxis in 6/12 (50.0%) patients (p = 0.0301). The OIT group demonstrated significant reductions in SPT wheal diameters, sIgE levels, and sIgE/total IgE ratios (all p < 0.001), accompanied by increased sIgG4 levels. Conclusions: Early OIT with pasteurized egg white in children younger than two years with IgE-mediated egg allergy was associated with high desensitization rates, favorable short-term safety outcomes, and significant immunological changes. These findings support the potential role of early active intervention as an alternative to exclusive avoidance strategies in infants with egg allergy. Full article