Adverse Childhood Experiences, Associated Stressors and Comorbidities in Children and Youth with Fetal Alcohol Spectrum Disorder across the Child Protection and Justice Settings in Western Australia
Adverse Childhood Experiences, Associated Stressors and Comorbidities in Children and Youth with Fetal Alcohol Spectrum Disorder across the Child Protection and Justice Settings in Western Australia
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西澳大利亚州儿童保护和司法机构中患有胎儿酒精谱系障碍的儿童和青少年的不良童年经历、相关压力源和合并症
DOI：
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发表时间：
2021
期刊：
影响因子：
--
通讯作者：
Carmela F Pestell
中科院分区：
文献类型：
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作者：
Grace Kuen Yee Tan;M. Symons;James P Fitzpatrick;Sophia G Connor;D. Cross;Carmela F Pestell
背景资料：患有胎儿酒精谱系障碍（FASD）的人有不良童年经历（ACE）的风险，特别是那些有儿童保护或司法系统参与的人。FASD和受影响个体的心理社会脆弱性之间的复杂关系是合并症的重要临床风险因素。本研究（1）探讨了FASD患者的ACE和相关的压力源;（2）比较了仅参与儿童保护系统、仅参与司法系统、两者都参与或两者都不参与的FASD患者的ACE特征;（3）研究了ACE与共病状况（如情绪和神经发育障碍）之间的关系。方法：通过对西澳大利亚州诊断诊所的文件审查，回顾性收集数据。生活逆境编码使用标准化ACE问卷。211例FASD患者（71.6%为男性），平均年龄11.12岁（范围= 2-21岁）。结果：在整个样本中，饮酒/药物滥用（70.1%）和家庭暴力（51.7%）是两种最常见的ACE。在整个队列中，39.3%有四个或四个以上的ACE。报告的其他压力源包括参与儿童保护系统（69.7%），脱离学校（43.1%），法律问题（40.3%），短暂性（19.0%），记录欺凌的受害者（12.3%），创伤性脑损伤（9.0%）和无家可归（5.2%）。此外，参与儿童保护和司法系统的个人报告父母在家中饮酒/滥用药物、父母被监禁、遭受家庭暴力和情感/身体忽视的可能性比没有参与任何活动的人高4到11倍。在这个临床人群中，较高的生活逆境率与合并症数量的增加相关，p <0.001。具体而言，那些与FASD合并症，如依恋障碍（p =.001），物质使用障碍（p =.006），和PTSD（p <.001）也报告了较高的ACE score.Conclusion：ACE是常见的，在这个临床人群中，特别是那些曾参与儿童保护和司法系统。该临床人群中ACE增加与合并症增加相关。这突出表明，预防，干预和早期诊断FASD对于高危儿童减少ACE的负面影响非常重要。
Background: Individuals with Fetal Alcohol Spectrum Disorder (FASD) are at risk of having adverse childhood experiences (ACEs), especially those with child protection or justice system involvement. The complex relationship between FASD and psychosocial vulnerabilities in the affected individual is an important clinical risk factor for comorbidity. This study (1) explored the ACEs and associated stressors in individuals with FASD; (2) compared the ACEs profiles of those who had been involved with the child protection system only, justice system only, both or neither; (3) examined the relationship between ACEs and comorbid conditions such as mood and neurodevelopmental disorders. Methods: Data were collected retrospectively via file review from diagnostic clinics in Western Australia. Life adversity was coded using a standardised ACEs questionnaire. 211 participants (71.6% males) with FASD with a mean age of 11.12 (range = 2-21) were included in the total sample.Results: Exposure to drinking/substance misuse at home (70.1%) and domestic violence (51.7%) were the two most common ACEs across the total sample. In the entire cohort, 39.3% had four or more ACEs. Additional stressors reported were involvement with child protection system (69.7%), disengagement from school (43.1%), trouble with the law (40.3%), transiency (19.0%), documented victims of bullying (12.3%), traumatic brain injury (9.0%) and homelessness (5.2%). Further, individuals who had been involved with both the child protection and justice system were four to eleven times more likely than those without any involvement to report parental drinking/substance misuse at home, parental incarceration, exposure to domestic violence and emotional/physical neglect. Higher rates of life adversity in this clinical population were associated with an increased number of comorbidities, p <.001. Specifically, those with FASD who had comorbidities such as attachment disorder (p =.001), substance use disorder (p =.006), and PTSD (p <.001) also reported higher ACEs score.Conclusion: ACEs were common in this clinical population, particularly those who had been involved with both the child protection and justice system. Increased ACEs in this clinical population were associated with increased comorbidities. This highlights that prevention, intervention and early diagnosis of FASD are important for at risk children to reduce the negative effects of ACEs.
影响因子：
4.8
作者：
Sullivan, PM;Knutson, JF
通讯作者：
Knutson, JF
DOI：
10.2174/1874473711205020135
发表时间：
2012
期刊：
Current drug abuse reviews
影响因子：
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作者：
Solis,JessicaM;Shadur,JuliaM;Burns,AlisonR;Hussong,AndreaM
通讯作者：
Hussong,AndreaM