Adverse Childhood Experiences and Mental Health in WomenPathways of Infl uence in a Clinical Sample

  1. Yolanda Fontanil 1
  2. María Dolores Méndez 2
  3. Yolanda Martín-Higarza 3
  4. Patricia Solís-García 1
  5. Esteban Ezama 2
  1. 1 Universidad de Oviedo
    info

    Universidad de Oviedo

    Oviedo, España

    ROR https://ror.org/006gksa02

  2. 2 Servicio de Salud Mental del Principado de Asturias
  3. 3 Instituto de Medicina Legal, Gobierno del Principado de Asturias
Revista:
Psicothema

ISSN: 0214-9915 1886-144X

Año de publicación: 2021

Título del ejemplar: Monográfico Mariano Yela

Volumen: 33

Número: 3

Páginas: 399-406

Tipo: Artículo

DOI: 10.7334/PSICOTHEMA2021.39 DIALNET GOOGLE SCHOLAR lock_openAcceso abierto editor

Otras publicaciones en: Psicothema

Resumen

Antecedentes: aunque el impacto negativo de las Experiencias Adversas Infantiles (ACEs) en la salud mental ha sido constatado en investigaciones previas, las vías a través de las que afectan al bienestar psicológico no están claras. Este estudio transversal analizó la relación entre ACEs y presencia de disfunciones psíquicas y el papel de las estrategias de afrontamiento, la regulación emocional y el apego adulto en esta asociación. Método: formaron la muestra 207 mujeres que recibieron apoyo psicoterapéutico en los Servicios Públicos de Salud Mental en España. El 53,1% también fueron atendidas por psiquiatría. Se realizaron análisis descriptivos y asociativos de las variables implicadas. Resultados: el 48,3% informó de 4 o más ACEs, la correlación con la severidad de los síntomas fue significativa. Las ecuaciones de regresión mostraron que cuatro variables explicaban el 56,2% de la varianza: Miedo al Rechazo y Abandono, Descontrol, Rechazo y Reestructuración Cognitiva. Conclusiones: las ACEs están directamente asociadas con la gravedad de las disfunciones psíquicas. Estos datos sugieren que una adecuada exploración sensible a estas experiencias puede ser terapéutica. La relación entre tipo de adversidad y las variables estudiadas muestra vías indirectas a través de las cuales las ACEs afectan a la salud mental de las mujeres.

Referencias bibliográficas

  • Abel, K.M., & Newbigging, K. (2018). Addressing unmet needs in women’s mental health. British Medical Association. https://www.bma.org.uk/ media/2115/bma-womens-mental-health-report-aug-2018.pdf
  • Alonso, Y., Fernández, J., Fontanil, Y., Ezama, E., & Gimeno, A. (2018). Contextual determinants of psychopathology. The singularity of attachment as a predictor of mental dysfunction. Psychiatry Research, 261(January), 338-343. https://doi.org/10.1016/j.psychres.2018.01.010
  • Arslan, G. (2017). Psychological maltreatment, coping strategies, and mental health problems: A brief and effective measure of psychological maltreatment in adolescents. Child Abuse & Neglect, 68, 96-106. https://doi.org/10.1016/j.chiabu.2017.03.023
  • Bacigalupe, A., Cabezas, A., Bueno, M.B., & Martín, U. (2020). Gender as a determinant of mental health and its medicalization. SESPAS report 2020. Gaceta Sanitaria, 34(1), 61-67. https://doi.org/10.1016/j. gaceta.2020.06.013
  • Becker-Blease, K.A. (2017). As the world becomes trauma-informed, work to do. Journal of Trauma & Dissociation, 18(2), 131-138. https://doi.or g/10.1080/15299732.2017.1253401
  • Bowlby, J. (1979). The making and breaking of affectional bonds. Tavistock Publications.
  • Brooks, M., Graham-Kevan, N., Robinson, S.J., & Lowe, M. (2019). Trauma characteristics and posttraumatic growth: The mediating role of avoidance coping, intrusive thoughts and social support. Psychological Trauma: Theory, Research, Practice, and Policy, 11(2), 232-238. https://doi.org/10.1037/tra0000372
  • Cano, F.J., Rodríguez, L., & García, J. (2007). Spanish version of the Coping Strategies Inventory. Actas Españolas de Psiquiatría, 35(1), 29-39. https://idus.us.es/handle/11441/56854
  • Carver, C.S., Scheier, M.F., & Weintraub, J.K. (1989). Assessing coping strategies: A theoretically based approach. Journal of Personality and Social Psychology, 56(2), 267-283. https://doi.org/10.1037//0022- 3514.56.2.267
  • Caravaca-Sánchez, F., Fearn, N.E., Vidovic, K.R., & Vaughn, M.G. (2019). Female prisoners in Spain: Adverse childhood experiences, negative emotional states, and social support. Health & Social Work, 44(3), 157- 166. https://doi.org/10.1093/hsw/hlz013
  • Centers for Disease Control and Prevention (CDC) (2010). Adverse childhood experiences reported by adults five states, 2009. Morbidity and Mortality Weekly Report, 59(49), 1609-1613. https://www.cdc.gov/ mmwr/preview/mmwrhtml/mm5949a1.htm
  • Centro Nacional de Epidemiología (2018). Salud Mental y Salud Pública en España: vigilancia epidemiológica [Mental Health and Public Health in Spain: Epidemiological Surveillance]. http://gesdoc.isciii.es/ gesdoccontroller?action=download&id=09/01/2018-44802ce4e8
  • Choi, K.R., Stewart, T., Fein, E., McCreary, M., Kenan, K.N., Davies, J.D., Naureckas, S., & Zima, B.T. (2020). The impact of attachment-disrupting adverse childhood experiences on child behavioral health. The Journal of Pediatrics, 221, 224-229. https://doi.org/10.1016/j.jpeds.2020.03.006
  • Cloitre, M., Khan, C., Mackintosh, M.A., Garvert, D., Henn-Haase, C., Falvey, E., & Saito, J. (2019). Emotion regulation mediates the relationship between ACES and physical and mental health. Psychological Trauma: Theory, Research, Practice, and Policy, 11(1), 82-89. https://doi.org/10.1037/tra0000374
  • Cludius, B., Mennin, D., & Ehring, T. (2020). Emotion regulation as a transdiagnostic process. Emotion, 20(1), 37-42. https://doi.org/10.1037/ emo0000646
  • Davison, M.L., Bershadsky, B., Bieber, J., Silversmith, D., Maruish, M.E., & Kane, R.L. (1997). Development of a brief, multidimensional, selfreport instrument for treatment outcomes assessment in psychiatric settings: Preliminary findings. Assessment, 4(3), 259-276. https://doi. org/10.1177/107319119700400306
  • Department of Health & Social Care (2018). The women’s mental health Taskforce: Final report. https://assets.publishing.service.gov.uk/ government/uploads/system/uploads/attachment_data/file/765821/ The_Womens_Mental_Health_Taskforce_-_fi nal_report1.pdf
  • Dube, S.R. (2018). Continuing conversations about adverse childhood experiences (ACEs) screening: A public health perspective. Child Abuse & Neglect, 85, 180-184. https://doi.org/10.1016/j.chiabu.2018.03.007
  • Eisenberg, N., Spinrad, T.L., & Eggum, N.D. (2010). Emotion-related selfregulation and its relation to children’s maladjustment. Annual Review of Clinical Psychology, 6, 495-525. https://doi.org/10.1146/annurev. clinpsy.121208.131208
  • Felitti, V.J., Anda, R.F., Nordenberg, D., Williamson, D.F., Spitz, A.M., Edwards, V., Koss, M.P., & Marks, J.S. (1998). Relationship of childhood abuse and household dysfunction to many of the leading causes of death in adults. American Journal of Preventive Medicine, 14(4), 245-258. https://doi.org/10.1016/S0749-3797(98)00017-8
  • Finkelhor, D. (2018). Screening for adverse childhood experiences (ACEs): Cautions and suggestions. Child Abuse & Neglect, 85, 174-179. https:// doi.org/10.1016/j.chiabu.2017.07.016
  • Fontanil, Y., Ezama, E., & Alonso, Y. (2013). Validation of the Scale of Preferences and Expectations in Close Interpersonal Relationships (EPERIC). Psicothema, 25(2), 275-281. https://doi.org/10.7334/ psicothema2012.125
  • Gratz, K.L., & Roemer, L. (2004). Multidimensional assessment of emotion regulation and dysregulation: Development, factor structure, and initial validation of the diffi culties in Emotion Regulation Scale. Journal of Psychopathology and Behavioral Assessment, 26(1), 41-54. https://doi. org/10.1023/B:JOBA.0000007455.08539.94
  • Hervás, G., & Jódar, R. (2008). The spanish version of the Difficulties in Emotion Regulation Scale. Clínica y Salud, 19(2), 139-156. https:// www.redalyc.org/articulo.oa?id=180613875001
  • Howard, L.M., Ehrlich, A.M., Gamlen, F., & Oram, S. (2017). Gender-neutral mental health research is sex and gender biased. The Lancet Psychiatry, 4(1), 9-11. https://doi.org/10.1016/S2215-0366(16)30209-7
  • Hughes, K., Bellis, M.A., Hardcastle, K.A., Sethi, D., Butchart, A., Mikton, C., Jones, L., & Dunne, M.P. (2017). The effect of multiple adverse childhood experiences on health: A systematic review and meta-analysis. The Lancet Public Health, 2(8), e356-e366. https://doi. org/10.1016/S2468-2667(17)30118-4
  • Johnson, J., Chaudieu, I., Ritchie, K., Scali, J., Ancelin, M.L., & Ryan, J. (2020). The extent to which childhood adversity and recent stress influence all-cause, mortality risk in older adults. Psychoneuroendocrinology, 111, 104492. https://doi.org/10.1016/j.psyneuen.2019.104492
  • Larkin, H., Shields, J.J., & Anda, R.F. (2012). The health and social consequences of adverse childhood experiences (ACE) across the lifespan: An introduction to prevention and intervention in the community. Journal of Prevention & Intervention in the Community, 40(4), 263-270. https://doi.org/10.1080/10852352.2012.707439
  • Lazarus, R.S., & Folkman, S.F. (1984). Stress, appraisal, and coping. Springer Publishing Company.
  • Martín-Higarza, Y., Fontanil, Y., Méndez, M.D., & Ezama, E. (2020). The direct and indirect influences of adverse childhood experiences on physical health: A cross-sectional study. International Journal of Environmental Research and Public Health, 17(22), 8507. https://doi. org/10.3390/ijerph17228507
  • Merrick, M.T. (2019). Vital signs: Estimated proportion of adult health problems attributable to adverse childhood experiences and implications for prevention 25 states, 2015-2017. Morbidity and Mortality Weekly Report, 68(44), 999-1005. https://doi.org/10.15585/mmwr.mm6844e1
  • Mikulincer, M., & Shaver, P.R. (2012). An attachment perspective on psychopathology. World Psychiatry, 11(1), 11-15. https://doi. org/10.1016/j.wpsyc.2012.01.003
  • Ortega-Maldonado, A., & Salanova, M. (2016). Evolución de los modelos sobre el afrontamiento del estrés: hacia el coping positivo [Evolution of models on coping with stress: Towards positive coping]. Ágora de Salut, 3(30), 285-293. https://doi.org/10.6035/AgoraSalut.2016.3.30
  • Petruccelli, K., Davis, J., & Berman, T. (2019). Adverse childhood experiences and associated health outcomes: A systematic review and meta-analysis. Child Abuse & Neglect, 97, 104-127. https://doi. org/10.1016/j.chiabu.2019.104127
  • Rod, N.H., Bengtsson, J., Budtz-Jørgensen, E., Clipet-Jensen, C., TaylorRobinson, D., Andersen, A.M.N., Dich, N., & Rieckmann, A. (2020). Trajectories of childhood adversity and mortality in early adulthood: A population-based cohort study. The Lancet, 396(10249), 489-497. https://doi.org/10.1016/S0140-6736(20)30621-8
  • Rudenstine, S., Espinosa, A., McGee, A.B., & Routhier, E. (2019). Adverse childhood events, adult distress, and the role of emotion regulation. Traumatology, 25(2), 124-132. https://doi.org/10.1037/trm0000176
  • Sachs-Ericsson, N.J., Rushing, N.C., Stanley, I.H., & Sheffl er, J. (2016). In my end is my beginning: Developmental trajectories of adverse childhood experiences to late-life suicide. Aging & Mental Health, 20(2), 139-165. https://doi.org/10.1080/13607863.2015.1063107
  • Sandín, B., Valiente, R.M., Chorot, P., Santed, M.A., & Lostao, L. (2008). SA-45: A brief form of the SCL-90. Psicothema, 20(2), 290-296. http:// www.psicothema.com/psicothema.asp?id=3463
  • Schalinski, I., Breinlinger, S., Hirt, V., Teicher, M.H., Odenwald, M., & Rockstroh, B. (2019). Environmental adversities and psychotic symptoms: The impact of timing of trauma, abuse, and neglect. Schizophrenia Research, 205, 4-9. https://doi.org/10.1016/j.schres. 2017.10.034
  • Sheffler, J.L., Piazza, J.R., Quinn, J.M., Sachs-Ericsson, N.J., & Stanley, I.H. (2019). Adverse childhood experiences and coping strategies: Identifying pathways to resiliency in adulthood. Anxiety, Stress, & Coping, 32(5), 594-609. https://doi.org/10.1080/10615806.2019.1638699
  • Stanislawski, K. (2019). The Coping Circumplex Model: An integrative model of the structure of coping with stress. Frontiers in Psychology, 16(10), 694. https://doi.org/10.3389/fpsyg.2019.00694
  • Tobin, D.L., Holroyd, K.A., Reynolds, R.V., & Wigal, J. K. (1989). The hierarchical factor structure of the Coping Strategies Inventory. Cognitive Therapy and Research, 13(4), 343-361. https://doi. org/10.1007/BF0117347
  • Van der Hallen, R., Jongerling, J., & Godor, B.P. (2020). Coping and resilience in adults: A cross-sectional network analysis. Anxiety, Stress, and Coping, 33(5), 479-496. https://doi.org/10.1080/10615806.2020.1 772969
  • Varese, F., Smeets, F., Drukker, M., Lieverse, R., Lataster, T., Viechtbauer, W., Read, J., van Os, J., & Bentall, R. P. (2012). Childhood adversities increase the risk of psychosis: A meta-analysis of patient-control, prospective and cross-sectional cohort studies. Schizophrenia Bulletin, 38(4), 661-671. https://doi.org/10.1093/schbul/sbs050
  • Wang, A.W.T., Cheng, C.P., Chang, C.S., Chen, D.R., Chen, S.T., Shieh, V., Lo, A., & Hsu, W.Y. (2016). Does the factor structure of the brief COPE fit different types of traumatic events? European Journal of Psychological Assessment, 34(3), 162-173. https://doi. org/10.1027/1015-5759/a000321
  • World Health Organization (2009). Addressing adverse childhood experiences to improve Public Health: Expert consultation, 4-5-May 2009. https://www.who.int/violence_injury_prevention/violence/ activities/adverse_childhood_experiences/global_research_network_ may_2009.pdf
  • World Health Organization (2017). Depression and other common mental disorders: Global health estimates. https://apps.who.int/iris/bitstream/ handle/10665/254610/WHO-MSD-MER-2017.2-eng.pdf