Adverse Childhood Experiences and Mental Health in an Adolescent Partial Hospital Program

ABSTRACT

Childhood adversity has been associated with myriad physical, emotional, and mental health symptoms across the lifespan, including higher risk for substance abuse, depression, suicidal ideation, and premature mortality. The current study evaluates the association between cumulative adverse childhood experiences and mental health distress at admission and discharge in an adolescent partial hospital program. Data were collected from 157 adolescents through clinical assessments administered during admission and discharge procedures (Youth Outcomes Questionnaire Self-Report (YOQ-SR), Treatment Support Measure (TSM), and Center for Youth Wellness Adverse Childhood Experiences Questionnaire Teen (CYW ACE-Q Teen)). Regression analyses were conducted to assess how cumulative ACEs predict admission mental health distress (Intrapersonal Distress, Critical Items, and Total Score) as well as mental health distress at discharge, above and beyond other clinically relevant factors. While ACEs significantly predicted overall distress at admission (p = .026), there were no other significant associations between ACEs and outcomes at admission, nor ACEs and any outcomes at discharge. This suggests experiences of adversity may not hinder or influence outcomes over the course of treatment in this setting. Experiences of adversity were highly endorsed in this sample; thus, further understanding of experiences of trauma and resilience in acute treatment settings is a critical area for future research to improve interventions for adolescents.

Abbreviations: ACE(s): Adverse Childhood Experience(s); ACE-Q: Adverse Childhood Experience Questionnaire; APHP: Adolescent Partial Hospitalization Program; LOS: Length of Stay; NSSI: Non-Suicidal Self-Injury; PHP: Partial Hospitalization Program; Y-OQ: Youth Outcome Questionnaire; Y-OQ-SR: Youth Outcome Questionnaire Self-Report; TSM: Treatment Support Measure

Acknowledgments

We would like to thank the adolescents and their families who participated in the APHP, as well as our dedicated clinical team for all that they do for our patients.

Disclosure statement

The authors declare no competing interests.

Ethical approval

Institutional Review Board approval was obtained through Lifespan-Rhode Island Hospital IRB [ref 001717:45CFR46.110(5)].

Author contributions

Ad: development of research plan, data analysis, writing/editing manuscript, EF: research design/statistics consultation, writing/editing manuscript; DG: data collection and assistance with cleaning data; MH: guidance on research design and development, editing manuscript; LM: statistical consultation, editing manuscript.

Additional information

Funding

This study was conducted without external grant funding. Dr. Micalizzi is supported by NIH grant [K01DA048135].