Associations between Positive Childhood Experiences (PCEs), Discrimination, and Internalizing/Externalizing in Pre-Adolescents

IF 3 3区医学 Q1 PEDIATRICS

Academic Pediatrics Pub Date : 2024-11-01 DOI:10.1016/j.acap.2024.07.006

Kristen R. Choi PhD, PMHNP-BC , Lilian Bravo PhD, RN , Jaime La Charite MD, MPH , Elizabeth Cardona BS , Thomas Elliott MD, MS , Kortney F. James PhD, PNP , Lauren E. Wisk PhD , Erin C. Dunn ScD, MPH , Altaf Saadi MD, MS

{"title":"Associations between Positive Childhood Experiences (PCEs), Discrimination, and Internalizing/Externalizing in Pre-Adolescents","authors":"Kristen R. Choi PhD, PMHNP-BC , Lilian Bravo PhD, RN , Jaime La Charite MD, MPH , Elizabeth Cardona BS , Thomas Elliott MD, MS , Kortney F. James PhD, PNP , Lauren E. Wisk PhD , Erin C. Dunn ScD, MPH , Altaf Saadi MD, MS","doi":"10.1016/j.acap.2024.07.006","DOIUrl":null,"url":null,"abstract":"<div><h3>Objective</h3><div>This study aimed to investigate the relationships between four types of perceived discrimination (based on race and ethnicity, nationality/country of origin, gender identity, weight/body size), individually and cumulatively; positive childhood experiences (PCEs); and behavioral symptoms among pre-adolescent youth.</div></div><div><h3>Methods</h3><div>This study was a secondary analysis of data from the Adolescent Brain Cognitive Development (ABCD) Study, a US-based cohort study of pre-adolescent youth in the United States (N = 10,915). Our outcome was emotional/behavioral symptoms measured by the Child Behavior Checklist. Primary exposures were four types of discrimination, a count of 0–5 PCEs, and other adverse childhood experiences (ACEs). Multiple logistic regression models were used to estimate the relationship between perceived discrimination and clinical-range behavioral symptoms, including the role of PCEs and ACEs.</div></div><div><h3>Results</h3><div>Weight discrimination was the most frequent exposure (n = 643, 5.9%). Race and weight perceived discrimination were associated with clinical-range externalizing and internalizing symptoms, respectively, but these associations were non significant once other ACEs were added to models. Cumulative discrimination was associated with clinical-range Child Behavior Checklist (CBCL) scores, even when accounting for other ACEs (aOR=1.47, 95% CI=1.2–1.8). PCEs slightly reduced the strength of this relationship and were independently associated with reduced symptoms (aOR=0.82, 95% CI=0.72–0.93).</div></div><div><h3>Conclusions</h3><div>Results of this national study suggest cumulative discrimination can exert emotional/behavioral health harm among youth. PCEs were independently associated with reduced behavioral symptoms. There is a need for further research on how to prevent discrimination and bolster PCEs by targeting upstream social inequities in communities.</div></div>","PeriodicalId":50930,"journal":{"name":"Academic Pediatrics","volume":"24 8","pages":"Pages 1236-1245"},"PeriodicalIF":3.0000,"publicationDate":"2024-11-01","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"","citationCount":"0","resultStr":null,"platform":"Semanticscholar","paperid":null,"PeriodicalName":"Academic Pediatrics","FirstCategoryId":"3","ListUrlMain":"https://www.sciencedirect.com/science/article/pii/S1876285924002754","RegionNum":3,"RegionCategory":"医学","ArticlePicture":[],"TitleCN":null,"AbstractTextCN":null,"PMCID":null,"EPubDate":"","PubModel":"","JCR":"Q1","JCRName":"PEDIATRICS","Score":null,"Total":0}

引用次数: 0

Abstract

Objective

This study aimed to investigate the relationships between four types of perceived discrimination (based on race and ethnicity, nationality/country of origin, gender identity, weight/body size), individually and cumulatively; positive childhood experiences (PCEs); and behavioral symptoms among pre-adolescent youth.

Methods

This study was a secondary analysis of data from the Adolescent Brain Cognitive Development (ABCD) Study, a US-based cohort study of pre-adolescent youth in the United States (N = 10,915). Our outcome was emotional/behavioral symptoms measured by the Child Behavior Checklist. Primary exposures were four types of discrimination, a count of 0–5 PCEs, and other adverse childhood experiences (ACEs). Multiple logistic regression models were used to estimate the relationship between perceived discrimination and clinical-range behavioral symptoms, including the role of PCEs and ACEs.

Results

Weight discrimination was the most frequent exposure (n = 643, 5.9%). Race and weight perceived discrimination were associated with clinical-range externalizing and internalizing symptoms, respectively, but these associations were non significant once other ACEs were added to models. Cumulative discrimination was associated with clinical-range Child Behavior Checklist (CBCL) scores, even when accounting for other ACEs (aOR = 1.47, 95% CI = 1.2–1.8). PCEs slightly reduced the strength of this relationship and were independently associated with reduced symptoms (aOR = 0.82, 95% CI = 0.72–0.93).

Conclusions

Results of this national study suggest cumulative discrimination can exert emotional/behavioral health harm among youth. PCEs were independently associated with reduced behavioral symptoms. There is a need for further research on how to prevent discrimination and bolster PCEs by targeting upstream social inequities in communities.

查看原文本刊更多论文

青春期前青少年的积极童年经历（PCEs）、歧视和内化/外化之间的关系。

研究目的本研究旨在调查四种感知到的歧视（基于种族/人种、国籍/原籍国、性别认同、体重/体型）单独和累积与积极童年经历（PCEs）和青春期前青少年行为症状之间的关系：本研究是对美国青少年大脑认知发展（ABCD）研究数据的二次分析，该研究是一项针对美国青春期前青少年的队列研究（N=10915）。我们的研究结果是以儿童行为检查表（Child Behavior Checklist）测量的情绪/行为症状。主要暴露是四种类型的歧视、0-5 个 PCEs 计数以及其他不良童年经历 (ACEs)。多重逻辑回归模型用于估计感知到的歧视与临床范围行为症状之间的关系，包括 PCE 和 ACE 的作用：结果：体重歧视是最常见的暴露（n=643，5.9%）。种族和体重歧视分别与临床范围的外化症状和内化症状相关，但在将其他ACE加入模型后，这些相关性并不显著。累积性歧视与临床范围的 CBCL 分数相关，即使考虑到其他 ACEs 也是如此（aOR=1.47，95% CI=1.2-1.8）。PCEs 稍微降低了这种关系的强度，并与症状减轻独立相关（aOR=0.82，95% CI=0.72-0.93）：这项全国性研究的结果表明，累积性歧视会对青少年的情绪/行为健康造成伤害。PCEs 与行为症状的减少有独立关联。有必要进一步研究如何通过针对社区中的上游社会不平等现象来预防歧视和加强 PCEs。

本文章由计算机程序翻译，如有差异，请以英文原文为准。

求助全文

约1分钟内获得全文求助全文

来源期刊

Academic Pediatrics PEDIATRICS-

CiteScore

4.60

自引率

12.90%

发文量

300

审稿时长

60 days

期刊介绍： Academic Pediatrics, the official journal of the Academic Pediatric Association, is a peer-reviewed publication whose purpose is to strengthen the research and educational base of academic general pediatrics. The journal provides leadership in pediatric education, research, patient care and advocacy. Content areas include pediatric education, emergency medicine, injury, abuse, behavioral pediatrics, holistic medicine, child health services and health policy,and the environment. The journal provides an active forum for the presentation of pediatric educational research in diverse settings, involving medical students, residents, fellows, and practicing professionals. The journal also emphasizes important research relating to the quality of child health care, health care policy, and the organization of child health services. It also includes systematic reviews of primary care interventions and important methodologic papers to aid research in child health and education.