%0 Journal Article %J Prevention Science %D 2016 %T Planning for long-term follow-up: Strategies learned from longitudinal studies %A Hill, Karl G. %A Woodward, Danielle %A Woelfel, Tiffany %A Hawkins, J D %A Green, Sara %B Prevention Science %V 17 %P 806-818 %G eng %0 Journal Article %J Int Public Health J %D 2016 %T Stress pathways to health inequalities: Embedding ACEs within social and behavioral contexts. %A Nurius, Paula S %A Green, Sara %A Logan-Greene, Patricia %A Longhi, Dario %A Song, Chiho %X

OBJECTIVE: This study addresses whether adverse childhood experiences (ACEs) demonstrate disproportional prevalence across demographic- and health-affecting characteristics, offer significant explanation of adult health outcomes, and show patterned association with illness susceptibility early within and across adulthood when viewed in combination with income and psychosocial resources.

METHODS: Data were derived from a population-based state health survey using stratified random sampling of household adults (n=7,470): ages 18-99 (M=55), 59.9% females, and race/ethnicity, income and education levels representative of the region. We assessed ACEs by aggregating 8 adversity forms, 5 health behaviors and 3 psychosocial resources; and health outcomes (number of chronic conditions, subjective wellness).

RESULTS: Disproportionality was evident in ACEs levels by demographics, adult SES, health behaviors, and psychosocial resources in expected directions. Stepped multiple regressions of health outcomes demonstrated significant betas and R(2) change for each predictor block, revealing cumulative as well as unique explanatory utility. Early onset chronic illness was evident on the basis of ACEs levels. These illnesses were amplified for low income respondents. Prevalence was highest across adulthood for those also reporting low psychosocial assets.

CONCLUSIONS: Findings offer novel insights as to the "long reach" of childhood adversity on health, conditioned by circumstances under which these effects may occur. Health resilience offered by health behaviors and psychosocial resources should shape thinking about preventive and remedial interventions by social work and allied professionals across a range of settings.

%B Int Public Health J %V 8 %P 241-256 %8 2016 Apr-Jun %G ENG %N 2 %1 http://www.ncbi.nlm.nih.gov/pubmed/27274786?dopt=Abstract %0 Journal Article %J Child Abuse Negl %D 2015 %T Life course pathways of adverse childhood experiences toward adult psychological well-being: A stress process analysis. %A Nurius, Paula S %A Green, Sara %A Logan-Greene, Patricia %A Borja, Sharon %K Activities of Daily Living %K Adaptation, Psychological %K Adult %K Adult Survivors of Child Abuse %K Aged %K Behavioral Risk Factor Surveillance System %K Crime Victims %K Female %K Health Surveys %K Humans %K Male %K Mental Health %K Middle Aged %K Multivariate Analysis %K Personal Satisfaction %K Regression Analysis %K Socioeconomic Factors %K Stress, Psychological %K Washington %X

Growing evidence suggests that toxic stressors early in life not only convey developmental impacts but also augment risk of proliferating chains of additional stressors that can overwhelm individual coping and undermine recovery and health. Examining trauma within a life course stress process perspective, we posit that early childhood adversity carries a unique capacity to impair adult psychological well-being both independent of and cumulative with other contributors, including social disadvantage and stressful adult experiences. This study uses data from a representative population-based health survey (N=13,593) to provide one of the first multivariate assessments of unique, cumulative, and moderated effects of adverse childhood experiences (ACEs) toward explaining 3 related yet distinct measures of adult mental health: perceived well-being, psychological distress, and impaired daily activities. Results demonstrate support for each set of hypothesized associations, including exacerbation and amelioration of ACEs effects by adult stress and resilience resources, respectively. Implications for services and future research are discussed.

%B Child Abuse Negl %V 45 %P 143-53 %8 2015 Jul %G eng %1 http://www.ncbi.nlm.nih.gov/pubmed/25846195?dopt=Abstract %R 10.1016/j.chiabu.2015.03.008 %0 Journal Article %J Soc Work Health Care %D 2014 %T Distinct contributions of adverse childhood experiences and resilience resources: a cohort analysis of adult physical and mental health. %A Logan-Greene, Patricia %A Green, Sara %A Nurius, Paula S %A Longhi, Dario %K Adaptation, Psychological %K Adolescent %K Adult %K Age Distribution %K Aged %K Behavioral Risk Factor Surveillance System %K Child Abuse %K Cohort Studies %K Female %K Health Status %K Humans %K Life Change Events %K Male %K Mental Health %K Middle Aged %K Regression Analysis %K Resilience, Psychological %K Self Concept %K Stress, Psychological %K Washington %K Young Adult %X

Although evidence is rapidly amassing as to the damaging potential of early life adversities on physical and mental health, as yet few investigations provide comparative snapshots of these patterns across adulthood. This population-based study addresses this gap, examining the relationship of adverse childhood experiences (ACEs) to physical and mental health within a representative sample (n = 19,333) of adults, comparing the prevalence and explanatory strength of ACEs among four birth cohorts spanning ages 18-79. This assessment accounts for demographic and socioeconomic factors, as well as both direct and moderating effects of resilience resources (social/emotional support, life satisfaction, and sleep quality). Findings demonstrate (1) increasing trends of reported ACEs across younger cohorts, including time period shifts such as more prevalent family incarceration, substance abuse, and divorce, (2) significant bivariate as well as independent associations of ACEs with poor health within every cohort, controlling for multiple covariates (increasing trends in older age for physical health), and (3) robust patterns wherein resilience resources moderated ACEs, indicating buffering pathways that sustained into old age. Theoretical and practice implications for health professionals are discussed.

%B Soc Work Health Care %V 53 %P 776-97 %8 2014 %G eng %N 8 %1 http://www.ncbi.nlm.nih.gov/pubmed/25255340?dopt=Abstract %R 10.1080/00981389.2014.944251 %0 Journal Article %J J Hum Behav Soc Environ %D 2013 %T Spouse Psychological Well-Being: A Keystone to Military Family Health. %A Green, Sara %A Nurius, Paula S %A Lester, Patricia %X

Understanding predictors of military spouse psychosocial vulnerability informs efforts to assess, identify, and support at-risk spouses and families. In this analysis we test the effects of family stress and strain on military spouse psychological health, using a sample of female civilian spouses (n=161). Regression findings confirm expectations of the significant contribution of family stressors, strain, and resources in explaining variation in spouses' psychological health, controlling for deployment and socioeconomic factors. Identifying the effects of family stress on military spouse psychological health supports the need for family-centered interventions and prevention programs.

%B J Hum Behav Soc Environ %V 23 %8 2013 Jan 1 %G eng %N 6 %R 10.1080/10911359.2013.795068 %0 Journal Article %J J Prev Interv Community %D 2012 %T Adverse childhood experiences (ACE) within a social disadvantage framework: distinguishing unique, cumulative, and moderated contributions to adult mental health. %A Nurius, Paula S %A Logan-Greene, Patricia %A Green, Sara %K Adult %K Adult Survivors of Child Abuse %K Aged %K Behavioral Risk Factor Surveillance System %K Child %K Child Abuse %K Crime Victims %K Cross-Sectional Studies %K Female %K Humans %K Male %K Mental Health %K Middle Aged %K Poverty %K Public Policy %K Washington %X

The deleterious impact of adverse childhood experiences (ACE) may be confounded with frequently co-occurring social disadvantage. In this analysis we test the effects of ACE on adult mental health within a social disadvantage framework, using a population-based survey (n = 7,444; mean age = 55.2 years) from Washington State. We also examined the protective effects of socioemotional support, and the distinct and combined contribution of the measured ACE factors. Results demonstrated sustained impact of ACE on mental health many decades later, even net of social disadvantage and demographic contributors. Protective factors provided both direct and moderating influences, potentially masking the elevated effects of ACE for those with few resources. Toxicity examination of ACE items evinced differential effects of ACE experiences on mental health. These results demonstrate that interventions ameliorating the effects of ACE and bolstering protective resources such as socioemotional support may be effective toward augmenting mental health even late in life.

%B J Prev Interv Community %V 40 %P 278-90 %8 2012 %G eng %N 4 %R 10.1080/10852352.2012.707443