Trends in the dose-response relationship between adverse childhood experiences and maladaptive metacognitive beliefs: A cross-sectional study.

BACKGROUND: Since the publication of the major research on adverse childhood experiences (ACE) at the turn of the millennium, our knowledge about the prevalence and physical and mental consequences of childhood adversities has increased substantially. In parallel, research on metacognition, which plays an important role in understanding our mental functioning, has also been on the rise. Although the adverse effects of ACEs on mental processes and the role of metacognitive deficits in the development of mental disorders are widely known, hardly any research into the interaction between these two areas has been conducted; this is what triggered our investigation. METHODS: Our research was carried out as a cross-sectional study on a sample of 304 members of the general population. We measured ACEs with the 10-item Adverse Childhood Experiences Questionnaire and maladaptive metacognitions-positive and negative metacognitive beliefs, cognitive confidence, cognitive self-consciousness, and need to control thoughts- using the Meta-Cognitions Questionnaire. The closeness of the relationship between the ACE score and metacognitions was measured using Pearson's linear correlation coefficient, while the association of ACE accumulation with metacognitive beliefs was assessed using generalized linear models. RESULTS: The most common ACE in our sample turned out to be emotional neglect (44.74%). All the examined maladaptive metacognitive beliefs correlate mildly to moderately with the number of suffered ACEs (r = 0.13-0.34), with an increase in the ACE score leading to a rise in the salience of maladaptive metacognitive beliefs. Moreover, a dose-response relationship was seen between increases in ACE scores and the overall values of metacognition, negative metacognitive beliefs, and the maladaptive metacognitive belief of the need to control thoughts. CONCLUSIONS: Our results suggest that the more ACEs were experienced in childhood, the more pronounced the dysfunctional metacognitive beliefs are. Therefore, our findings emphasize the importance of further research into the topic.

Validity and reliability of the 10-Item Adverse Childhood Experiences Questionnaire (ACE-10) among adolescents in the child welfare system.

Introduction: Multiple evidence suggests that the vast majority of children in the Child Welfare System (CWS) are victims of early, chronic, and multiple adverse childhood experiences. However, the 10-item version of the Adverse Childhood Experiences Questionnaire (ACE-10) has never been tested in such a particularly vulnerable population as adolescents living in the CWS. We aimed to assess the psychometric properties of the ACE-10 in a community sample of 240 Hungarian adolescents placed in family style group care (FGC) setting. Methods: Demographic data, the 10-item version of the Adverse Childhood Experiences Questionnaire (ACE-10), the Strengths and Difficulties Questionnaire (SDQ), and the HBSC Bullying Measure were used. Results: Our results showed acceptable internal consistency (α = 0.701) and item-total correlations (rpb = 0.25-0.65, p < 0.001). However, our results also reflect that item 6 ("Parental separation/divorce") is weakly correlated with both the cumulative ACE score and the rest of the questionnaire items. When item 6 is removed, the 9-item version of the ACE produces more favorable consistency results (α = 0.729). Strong and significant associations of the cumulative ACE score with emotional and behavioral symptoms and bully victimization confirm the concurrent criterion validity of both versions of the instrument. Discussion: Our findings suggest that ACE-9 and ACE-10 are viable screening tools for adverse childhood experiences in the CWS contributing to the advancement of trauma-informed care. We recommend considering the use of either the 9-item or the 10- item version in the light of the characteristics of the surveyed population. The implications and limitations are discussed.

[The impact of adverse childhood experiences on mental and somatic health in childhood and adolescence]. / Az ártalmas gyermekkori élmények hatása a mentális és szomatikus egészségre gyermek- és serdülokorban.

Multiple studies prove that children who were exposed to adverse childhood experiences within their families are increasingly at risk of various high-risk behaviours, bullying, mental and somatic disorders. In children/adolescents who undergo terrifying experiences on a repetitive, sometimes daily basis without being provided support and the basic safety they would need, all aspects of personality development will be seriously affected. Urgent action is needed in Hungary to identify these children and provide them with therapeutic support. The field of childhood adversities and their consequences has been undeservedly neglected by research, despite the fact that preventive and therapeutic interventions could be specifically designed based on this knowledge during childhood and adolescence. In our study, we present international data on the prevalence of adverse childhood experiences. We discuss in detail the association of adverse childhood experiences with biological and cognitive impairments attachment disorders, externalising and internalising disorders, somatic disorders and health risk behaviours in childhood and adolescence. Besides presenting empirical data on adverse experiences and consequences, the purpose of our publication is to raise awareness and sensitisation among professionals. Orv Hetil. 2023; 164(37): 1447-1455.

[The immediate impact of different types of cartoons on preschoolers' executive function].

OBJECTIVE: The aim of this study was to examine whether different types of cartoons (related and unrelated shifts, cuts and other formal features) immediately influence preschool-aged children's executive function (e.g. working memory, inhibition). METHODS: Participants were 29 children aged four to five years. They were assigned to watch a fast-paced cartoon that used high concentrations of perceptually salient features or an educational cartoon or draw for 10 minutes. Preschoolers' executive function was assessed via 4 tasks (Sentence repetition, Hand game, Tower of Hanoi, Multi step commands). Parents completed questionnaires regarding demographics and the media habits and executive function of the participating child. RESULTS: Using age as a covariate we found a significant main effect of intervention on the composite executive function score. The fast paced television group performed significantly worse on the executive function tasks than the drawing group. The difference between the fast-paced and the educational cartoon groups approached significance, and there was no difference between drawing and watching the slow-paced cartoon. CONCLUSION: The effects of media consumed during early childhood are mediated not only by quantity but also by the formal features of television programming. Just one episode of viewing a fast-paced cartoon has (at least a short-term) negative effect on preschoolers' executive function.

Psychometric properties of the Adverse Childhood Experiences Questionnaire 10 item version (ACE-10) among Hungarian adolescents.

Introduction: Although a number of studies have been conducted since the 1995 initiation of the ACE study to map the effects of adverse childhood experiences, few studies have examined the psychometric properties of the individual versions of the ACE questionnaire. Aims: The Adverse Childhood Experiences Questionnaire 10 item version (ACE-10) has only been tested in a single study in an adult population, while its applicability in a particularly vulnerable population, the adolescents, has not been investigated yet. Our present study aims to address this gap in an adolescent sample of 792 subjects from a non-representative general population. Methods: Besides demographic data, the Adverse Childhood Experiences Questionnaire 10 item version (ACE-10), the Strengths and Difficulties Questionnaire (SDQ), and the HBSC Symptom Checklist (HBSC-SCL) were employed. Results: Our results showed acceptable internal consistency (ɵ = 0.86, α = 0.64) and adequate internal validity (r = 0.28-0.70, p < 0.001). In addition, proper concurrent criterion validity of the questionnaire was found when tested along the SDQ and HBSC-SCL items. Conclusion: Our results demonstrate that the ACE-10 is suitable for assessing intrafamilial adverse childhood experiences in adolescents.

Adverse childhood experiences increase the risk for eating disorders among adolescents.

Purpose: Traumatic events often feature prominently in eating disorders. A questionnaire survey to assess the relation of eating disorder risk to the frequency of adverse childhood experiences (ACEs) and the possible association of eating disorder risk with a particular type of ACE was conducted in a community sample of Hungarian adolescents. Methods: Demographic and anthropometric data, risk for eating disorders (by SCOFF questionnaire), and ACEs (by ACE score calculator) were collected from 432 adolescents aged 12-17 years. Results: Adolescents who had undergone four or more ACEs were 5.7 times more likely to be in the high eating disorder risk group than those who did not report any ACEs. Cumulative maltreatment showed a greater association with overall risk for eating disorders than cumulative family dysfunction. There is an increased risk of eating disorders from emotional maltreatment (OR = 3.475), physical maltreatment (OR = 3.440), sexual maltreatment (OR = 10.973), and emotional neglect (OR = 3.331). Dysfunctional family circumstances revealed an association with household mental illness (OR = 3.401). Conclusion: Our study of the connection between eating disorder risk and ACE is the first of its kind in Central and Eastern Europe. Maltreatments had a greater role than family dysfunctions in increasing the risk of eating disorders. Our findings contribute to a more precise understanding of the role that ACEs play in eating disorders. It is important to bring to clinicians' attention the importance of ACEs in the diagnosis and therapy of eating disorders and their potentially fundamental significance for therapy.

Can the Cumulative Adverse Childhood Experiences (ACE) Score Actually Identify the Victims of Intrafamilial Childhood Maltreatment? Findings from a Study in the Child Welfare System.

Studies show that a significant proportion of children in the Child Welfare System (CWS) have suffered adverse childhood experiences (ACEs), which have led to well documented serious consequences. This study assessed and compared the ACE status of adolescents aged 12 to 17 placed in a family style group care (FGC) setting (n = 240) to the ACE status of adolescents living with their biological parents (n = 516). The ACE Score Calculator was employed. The populational differences in ACE scores and in the prevalence of ACEs were assessed using generalized linear and logistic regression models. Adolescents living in FGC settings reported more than five times as many multiple adverse experiences (≥4 types of ACEs) as those living with their biological parents. Adolescents living in FGC settings seem to be more willing to report family dysfunction rather than their maltreatment history and are less willing to report maltreatment. In the FGC group, a surprisingly high proportion of adolescents reported having experienced no maltreatment, which is probably highly underreported and/or unrecognised in the CWS. In fact, a high ACE score will not identify the children who have experienced direct maltreatment but will highlight the consequences of the unfavourable factors inherent in disadvantaged social situation instead.

[The relationship of muscle dysmorphia to the body image and early maladaptive schemata created by parental behaviours].

INTRODUCTION: the purpose of our study was to investigate the link between specific traits that determine muscle dysmorphia in bodybuilders and the parental behaviours which play a role in developing these schemata, as well as the eating-disorder-specific traits which differentiate bodybuilders from the normal population. AIM: conceptualising the similarities of personality traits in case of muscle dysmorphia and eating disorders, as well as their etiology based on the schema theory. METHOD: to measure muscle dysmorphia was used the Muscle Appearance Satisfaction Scale. We explored its connec - tion with eating disorders applying the Eating Disorder Inventory and thereof with the parental behaviours was used the Young Parental Inventory. RESULTS: a number of eating-disorder-specific traits differentiate persons with muscle dysmorphic traits from the normal population. These are Drive for thinness, Body dissatisfaction, Feeling of inadequacy, Interoceptive awareness and Perfectionism. Regarding the perceived parental behaviour the father violated the child's need of autonomy, compe - tence and self-identity and the mother violated the need of boundaries and self-control. CONCLUSIONS: Based on several personality characteristics, muscle dysmorphia may be related to anorexia nervosa and bulimia nervosa. In its etiology parental care can have a role, as the father is disposed to detain the autonomy, and the expression of personal needs, while the mother demonstrates insufficient control functions, and the detention of the autonomy and the need for competency.

Assessing adverse childhood experiences, social, emotional, and behavioral symptoms, and subjective health complaints among Hungarian adolescents.

BACKGROUND: Adverse Childhood Experiences (ACEs) can have lifelong adverse impacts; they can play a role in the development of subsequent emotional, cognitive, and social impairments leading to somatic and mental difficulties, as well as health damaging behaviours. Unfortunately, there are currently no research data available in Hungary regarding the frequency of ACEs among adolescents. AIMS: A cross sectional questionnaire survey was conducted in a community sample of Hungarian adolescents to assess the frequency of ACEs and analyse their association with current social, emotional, and behavioural symptoms (SEB), and subjective health complaints (SHC). METHODS: Demographic data, ACEs, SEB and SHC status of 516 adolescents aged 12 to 17 were collected. ACEs were assessed using the ACE Score Calculator; for SEB the Strengths and Difficulties Questionnaire, and for SHC some specific items from the Health Behaviour of School Children questionnaire were employed. To analyse the relationship of ACEs to SEB and SHC logistic regression was performed. RESULTS: Our results showed that the frequency of ACEs, SEB and SHC is high among adolescents. One-fourth of the students reported ≥ 2 categories of childhood exposures, and 7.4% reported having experienced ≥ 4 types of ACEs. The most prevalent forms of child maltreatment were emotional neglect (15.5%) and emotional abuse (14.5%). The most frequent dysfunctional household condition was parental divorce or separation (23.8%), followed by household substance abuse (8.9%) and household mental illness (8.1%). Almost one-fifth of students (17.5%) reported SEB symptoms (peer relationship problems in 21.7%, emotional symptoms in 14.6%, conduct problems in 18.3%, hyperactivity in 15%). The prevalence of SHC was also high: more than half of the students experienced at least one subjective health complaint multiple times a week. Significant associations were found between ACEs and the SEB/SHC reported by students. CONCLUSIONS: Adverse childhood experiences, social, emotional, and behavioural symptoms, and SHC are common among Hungarian adolescents. The cumulation of ACEs is associated with a higher number of SEB and SHC symptoms. Therefore, prevention programmes, early recognition, risk reduction, and therapy are needed.

[The role of traumatization in eating disorders. Possible therapeutic modalities with special regard to cognitive behavioural methods].

In the complex pathomechanism of eating disorders (especially that of bulimia nervosa and binge eating disorder) the traumatic experiences (sexual, physical, emotional abuse, neglect) often play an important role. The consequence of traumas can be the borderline personality disorder, or different disorders of the emotional regulation. These occur mainly in the multiimpulsive subtype of eating disorders with impulse control disorders. In relation to the trauma dissociative phenomena are frequent. In the diagnostics of eating disorders the history of traumatization is essential. Among the therapeutical possibilities the psychodynamic approach is important. Moreover, the newer methods based on cognitive behavioral therapy are effective, e.g., dialectic behavior therapy, integrative cognitive-analytic therapy, and other complex programs of trauma processing, such as the trauma-informed care.