Patient Preferences for Discussing Childhood Trauma in Primary Care

Goldstein, Ellen; Athale, Ninad; Sciolla, Andrés F; Catz, Sheryl L.

doi:10.7812/tpp/16-055

Cited by 64 publications

(58 citation statements)

References 46 publications

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“…22 Patients are willing to discuss trauma exposure and believe their clinicians will be able to provide assistance in a sensitive manner. 20 Education and training on ACE screening can mitigate clinician discomfort, a sentiment echoed throughout the studies included in this review.…”

Section: Implementation Of Ace Screeningmentioning

confidence: 99%

“…7 Adult patients with or without trauma history also felt that it was acceptable to be assessed for past trauma and expected their clinician would be able to help them. 20 Adult patients in a study by Flanagan et al 21 voiced acceptability, with over half of the respondents reporting that screening increased trust in their clinician, and 75% felt it helped their clinician know them better. Kalmakis et al 16 noted the positive association between ACE scores, chronic health conditions, and clinic visits and recognized that time spent addressing ACEs has the potential to affect patients' overall care.…”

Section: Acceptability Of Ace Screeningmentioning

confidence: 99%

“…Although perceived barriers were noted before the implementation of ACE screenings, 8 studies echoed similar themes addressing feasibility postimplementation. 12,16,[19][20][21][22]25,26 Clinicians perceived ACE screenings to help develop a deeper clinician-patient relationship, highlight the mind and body connection, and foster integrated care. 25 In the study by Gillespie and Folger, 12 clinicians felt ACE screenings fostered a trusting relationship, increased their empathy toward patients, and led to better communication.…”

Section: Feasibility Of Ace Screeningmentioning

confidence: 99%

See 2 more Smart Citations

Screening for Adverse Childhood Experiences: Literature Review and Practice Implications

Rariden¹,

SmithBattle²,

Yoo³

et al. 2021

The Journal for Nurse Practitioners

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Adverse childhood experiences (ACEs) are linked with negatively impacting child and adult health outcomes. Clinicians are integral in identifying childhood adversities and offering supportive measures to minimize negative effects. This systematic literature review included 13 ACE studies that examined the acceptability, feasibility, and implementation of ACE screenings from the perspectives of clinicians and patients. The findings of this review can assist clinicians in considering the appropriateness of ACE screenings for their patients and the ethical and practical issues that must be addressed for effective screening implementation.

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Section: Implementation Of Ace Screeningmentioning

confidence: 99%

Section: Acceptability Of Ace Screeningmentioning

confidence: 99%

Section: Feasibility Of Ace Screeningmentioning

confidence: 99%

See 1 more Smart Citation

Screening for Adverse Childhood Experiences: Literature Review and Practice Implications

Rariden¹,

SmithBattle²,

Yoo³

et al. 2021

The Journal for Nurse Practitioners

View full text Add to dashboard Cite

show abstract

“…Trauma-specific questions may also be emotionally invasive, triggering, and taxing to complete for some participants [41][42][43]. In contrast, some studies have noted that participating in research that assesses exposure to traumatic events is a neutral to positive experience for individuals who have experienced or are currently experiencing stress or adversity [43][44][45][46][47]. Given this mixed body of evidence, participants' willingness to respond to these measures is an important consideration in evaluating measures of adversity.…”

Section: Introductionmentioning

confidence: 99%

“…These professionals noted similar concerns and identified discomfort asking sensitive questions and worries about offending patients as additional barriers. Although past research has demonstrated that clinical screening for adversity is feasible, acceptable, and often supported by patients, parents, and providers [45,[54][55][56][57], it is not common practice. This observation highlights the need for screening methods that directly address these concerns yet allow for children's adversity to be easily assessed in clinical and primary care as well as in research settings.…”

Section: Introductionmentioning

confidence: 99%

The Child Life Challenges Scale (CLCS): Associations of a Single-Item Rating of Global Child Adversity with Children’s Total Life Stressors and Parents’ Childhood Adversity

et al. 2020

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Background: Although many existing measures tabulate specific risk factors to yield cumulative risk indices, there is a need for low-burden strategies to estimate general adversity exposure. Aims and Methods: This study introduces a brief, new measure of lifetime adversity, the Child Life Challenges Scale (CLCS), and examines its validity in a sample of parents and children residing in emergency housing. The CLCS comprises a single global item for rating cumulative life challenges utilizing either a paper-pencil scale or a sliding scale on a tablet. Parents are provided with anchor examples of mild and extreme challenges and asked to mark a location along the scale reflecting number and severity of challenges in their children’s lives to date. Study participants included 99 parents and their 3- to 6-year-old children. Results: CLCS scores were moderately associated with children’s parent-reported total life stressors, and these associations were robust to controls for parental history of adversity, parental distress, and family demographics. Control variables also did not moderate associations between CLCS scores and total life stressors, suggesting that the CLCS functions similarly across a range of sociodemographic risk. Paper-pencil and tablet versions showed similar convergent validity. Conclusion: The CLCS shows promise as an efficient measure for estimating children’s lifetime adversity with minimal parent or administrator burden.

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Association of Adverse Childhood Experiences With Cardiovascular Disease Later in Life

et al. 2021

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xposure to adversity early in life has been linked to negative long-term health outcomes. The consequences in late life of these adverse childhood experiences (ACEs), which include different forms of abuse, household dysfunction, and neglect, are now recognized. 1,2 ACEs have been traditionally related to an increased risk of psychological disturbances and substance use disorders. 3 The landmark Adverse Childhood Experiences study, authored by Felitti and colleagues 2 20 years ago, was the first study to propose that ACEs are also associated with the development of chronic physical conditions in adulthood, including cardiovascular disease (CVD). Since then, multiple studies have shown that traumatic events in childhood are associated with an increased likelihood of developing risk factors for CVD (eg, obesity, smoking, hypertension, diabetes) as well as CVD during the lifetime. 4 Interventions that mitigate the negative consequences of ACEs or prevent their initial onset may reduce the incidence of CVD. This narrative review summarizes the current literature regarding the association of ACEs with CVD and discusses possible pathophysiological mechanisms along with management approaches. ACE DefinitionACEs encapsulate a broad spectrum of traumatic and distressing events that threaten a child's physical, familial, or social safety and security before the age of 18 years. 4 These events may include direct mistreatment and neglect, exposure to household dysfunction, physical or sexual abuse, or violence. There are several methods of assessing ACEs. The initial Adverse Childhood Experiences study 2 introduced a 10-category ACE questionnaire to identify abuse, household dysfunction, or neglect up to age 18 years that is still used in its original and expanded versions. 5 Recently, additional factors, such as bullying, economic hardship, and loss of or severe disease in close persons, have also been recognized as ACEs (Table ). 6 ACEs tend to occur in clusters, such that individuals who experience at least 1 ACE are more likely to experience others, putting them at an even higher risk of poor future health. 7 Multiple ACEs may suggest a chaotic family environment that places not only individuals at risk but also family members, eliciting a potentially vicious cycle of intergenerational risk. 8 IMPORTANCE Adverse childhood experiences (ACEs) are potentially harmful events that occur during childhood, spanning neglect, physical or sexual abuse, parental separation, or death, among others. At least 50% of the US adult population has experienced 1 or more ACEs before the age of 18 years, but in clinical practice, ACEs remain underrecognized. Adults who have experienced ACEs are at increased risk of developing health risk behaviors and, ultimately, cardiovascular disease (CVD). This review summarizes the evidence regarding the association of ACEs with CVD and the accompanying diagnostic and therapeutic approaches in the adult population.OBSERVATIONS ACEs are commonly classified into 3 domains: abuse (psychological, phys...

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Patient Preferences for Discussing Childhood Trauma in Primary Care

Cited by 64 publications

References 46 publications

Screening for Adverse Childhood Experiences: Literature Review and Practice Implications

Screening for Adverse Childhood Experiences: Literature Review and Practice Implications

The Child Life Challenges Scale (CLCS): Associations of a Single-Item Rating of Global Child Adversity with Children’s Total Life Stressors and Parents’ Childhood Adversity

Association of Adverse Childhood Experiences With Cardiovascular Disease Later in Life

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