Adverse childhood experiences—household stressors and children’s mental health: a single centre retrospective review

Abstract

ObjectiveTo determine the prevalence of reported ‘household stressor’ adverse childhood experiences (ACEs) in families of children presenting with neurodevelopmental, behavioural or emotional difficulties and to determine whether family vulnerabilities, individually or cumulatively, were associated with particular clinical symptomatology.DesignRetrospective chart review followed by statistical analysis of family stressors and clinical symptomatology.SettingA community paediatric clinic in Australia.ParticipantsAll 267 children who attended an initial paediatric appointment during 2018.Results162 (60.7%) children had been exposed to one or more household stressor ACEs, including 116 (43.4%) children exposed to parental mental illness. Behavioural disturbance occurred in 144 (53.9%) children and externalising behaviours (other than attention deficit hyperactivity disorder) were more frequent than internalising behaviours. Externalising and internalising behaviours were associated with individual and cumulative household stressor ACEs. Most other symptomatology apart from genetic/neurological conditions, autistic symptoms and some developmental delays appeared to be partially associated with ACEs.ConclusionHousehold stressor ACEs were common, frequently occurred concurrently, and were associated with much of the symptomatology, in this cohort. Parental mental illness was the most prevalent stressor and behavioural disturbance the most prevalent symptomatology. These findings may have implications for clinical practice and service provision.

Examining adverse childhood experiences and attention deficit/hyperactivity disorder: A systematic review

“…Stressful childhood events such as ACEs have been shown to increase the possibility of the development of ADHD and increase the severity of symptoms. Four studies (Bauer et al, 2022; Bomysoad & Francis, 2020; Holmes et al, 2021; Jimenez et al, 2017; Zarei et al, 2021) demonstrate that stress which is specifically experienced within households is indicative of higher incidences of ADHD in children. Trauma was associated with, at age 11 years, ADHD and hyperactivity disorders (1·47 [1·01‐2·13]) (Bauer et al, 2022).…”

“…Trauma was associated with, at age 11 years, ADHD and hyperactivity disorders (1·47 [1·01‐2·13]) (Bauer et al, 2022). A study (Holmes et al, 2021) found that 60.7% of children presenting with ADHD had experienced one or more household stressor ACEs. A positive odds‐ratio (OR) > 1.0 association implied the presence of co‐occurring ACEs, thus, all five household stressor ACEs were positively associated with each other (Holmes et al, 2021).…”

“…A study (Holmes et al, 2021) found that 60.7% of children presenting with ADHD had experienced one or more household stressor ACEs. A positive odds‐ratio (OR) > 1.0 association implied the presence of co‐occurring ACEs, thus, all five household stressor ACEs were positively associated with each other (Holmes et al, 2021). Another study (Zarei et al, 2021) noted that there is a strong positive linear relationship between ADHD and ACEs.…”

“…Two studies (Holmes et al, 2021; Schickedanz et al, 2018) suggest that parents who have experienced ACEs have children who are more likely to be diagnosed with mental health conditions such as ADHD. Another study furthered this idea by showing a higher ACE score (per 1‐unit increase) was associated with a higher prevalence of any mental health condition (Uddin et al, 2020).…”

“…Another study furthered this idea by showing a higher ACE score (per 1‐unit increase) was associated with a higher prevalence of any mental health condition (Uddin et al, 2020). One study (Holmes et al, 2021) relied on reports from children, however, another study (Schickedanz et al, 2018) used information that was self‐reported by parents. Parenting styles and genetic factors affect children's development which leads to an increase in the possibility of adverse experiences (Schickedanz et al, 2018).…”