ABSTRACT
OBJECTIVE: To examine the impact of adverse childhood experiences (ACEs) and support on self-reported work inability of adults reporting disability. PARTICIPANTS: Adults (ages 18-64) who participated in the Behavioral Risk Factor Surveillance System in 2009 or 2010 and who reported having a disability (n = 13,009). DESIGN AND MAIN OUTCOME MEASURES: The study used a retrospective cohort design with work inability as the main outcome. ACE categories included abuse (sexual, physical, emotional) and family dysfunction (domestic violence, incarceration, mental illness, substance abuse, divorce). Support included functional (perceived emotional/social support) and structural (living with another adult) support. Logistic regression was used to adjust for potential confounders (age, sex and race) and to evaluate whether there was an independent effect of ACEs on work inability after adding other important predictors (support, education, health) to the model. RESULTS: ACEs were highly prevalent with almost 75% of the sample reporting at least one ACE category and over 25% having a high ACE burden (4 or more categories). ACEs were strongly associated with functional support. Participants experiencing a high ACE burden had a higher adjusted odds ratio (OR) [95% confidence interval] of 1.9 [1.5-2.4] of work inability (reference: zero ACEs). Good functional support (adjusted OR 0.52 [0.42-0.63]) and structural support (adjusted OR 0.48 [0.41-0.56]) were protective against work inability. After adding education and health to the model, ACEs no longer appeared to have an independent effect. Structural support remained highly protective, but functional support only appeared to be protective in those with good physical health. CONCLUSIONS: ACEs are highly prevalent in working-age US adults with a disability, particularly young adults. ACEs are associated with decreased support, lower educational attainment and worse adult health. Health care providers are encouraged to screen for ACEs. Addressing the effects of ACEs on health and support, in addition to education and retraining, may increase ability to work in those with a disability.
Subject(s)
Adult Survivors of Child Abuse/statistics & numerical data , Child Abuse/statistics & numerical data , Disabled Persons/statistics & numerical data , Work/statistics & numerical data , Adolescent , Adult , Adult Survivors of Child Abuse/psychology , Behavioral Risk Factor Surveillance System , Child , Child Abuse/psychology , Disability Evaluation , Disabled Persons/psychology , Female , Humans , Logistic Models , Male , Middle Aged , Models, Psychological , Perception , Professional Impairment/psychology , Professional Impairment/statistics & numerical data , Retrospective Studies , Risk Assessment/methods , Risk Assessment/statistics & numerical data , Social Support , Work/psychology , Young AdultABSTRACT
The number of custodial grandparents has increased significantly over the past decade. Building on Hayslip's and Kaminski's comprehensive review of the literature on custodial grandparenting, we conducted an updated review of the literature, in particular peer-reviewed journal articles published since 2004. We have developed a conceptual model to contribute to understanding the causes and consequences of custodial grandparenting, using the stress-coping framework while highlighting the emerging issues related to contemporary grandfamilies such as cultural and ethnic heterogeneity in grandfamilies. We also emphasized loss, grief, and trauma among grandfamilies and provided the implications for effective public and community health programs.
Subject(s)
Child Rearing/psychology , Grandparents/psychology , Models, Psychological , Stress, Psychological , Adaptation, Psychological , Child , Child Rearing/ethnology , Culture , Humans , Social SupportABSTRACT
OBJECTIVES: This paper examines the mediating effect of child-grandparent conflict on the relationship between child trauma exposure and grandparenting stress. METHODS: Data was collected from a sample of custodial grandparents who participated in kinship care or relative caregiving programs (n = 251). Grandparenting stress was measured with Parenting Stress Scale (Berry & Jones, 1995 ) modified for grandparents. A series of regression models and structural equation models (SEM) were used to test the relationship between the number of different types of child trauma exposures and grandparenting stress, and to examine the mediating effect of child-grandparent conflicts on the relationship. RESULTS: Almost three-fourths (72%) of children had experienced at least one type of traumatic exposure. The SEM model shows that child's trauma exposure indirectly affected grandparenting stress, mediated by child-grandparenting conflicts though no direct path between the child's trauma exposure variable and grandparenting stress was found. A higher level of child-grandparent conflicts was also associated with a lower level of emotional well-being among custodial grandparents. CONCLUSION: Based on these findings, recommendations are made about how to tailor a trauma-informed approach to the needs of custodial grandparents.
